Single Versus Multi‑visit Endodontic Treatment of Teeth with Apical Periodontitis: An In vivo Study with 1‑year Evaluation

Background: Apical periodontitis (AP) is one of the most prevalent diseases of the teeth. Treatment of AP is based on the removal of the cause, i.e., bacteria from the root canals. Achievement of adequate bacterial eradication in one appointment treatment remains a controversy.Aim: This prospective study was conducted with the objective to compare the periapical healing of teeth with AP treated in (a) single visit versus (b) two visits, either with or without Vitapex as an intracanal medicament.Subjects and Methods: Patients were selected randomly from the Department of Conservative Dentistry and Endodontics. Forty‑three patients (81 teeth) met the inclusion criteria, i.e., AP (both symptomatic and asymptomatic) visible radiographically size ≥2 mm × 2 mm, not suffering from any immune‑compromising disease, age between 16 and 65 years and tooth not accessed previously. Patients were randomly divided into three groups, i.e., single‑visit group (Group 1), multi‑visit group without any intracanal medicament (Group 2), and multi‑visit group with Vitapex as interim intracanal medicament (Group 3). Comparison was done radiographically using periapical index (PAI). The primary outcome measure was the change in periapical radiolucency after 1 year assessed by PAI scores. The Mann–Whitney U‑test was used to evaluate differences between groups at baseline (immediate postoperative) and at the 12‑month follow‑up evaluation. Change in PAI score for each group from baseline to 12‑month follow‑up evaluation was tested with the Wilcoxon signed rank test. The secondary outcome measures, proportion of teeth in each group that could be considered improved (decreased PAI score) or healed (PAI <2), were assessed with the Chi‑square test.Results: No statistically significant difference in periapical healing was found between three groups.Conclusion: After 1‑year evaluation, no difference in periapical healing was found between single‑visit treatment and multi‑visit treatment groups with the given sample size.Keywords: 1‑year evaluation, Apical periodontitis, Multi‑visit treatment, Single visit, Vitape

Pattern of regional metastasis in papillary thyroid cancer: our experience of 86 cases

Background: Papillary thyroid cancer (PTC) have a high propensity for regional metastasis which ranges from 30- 80%. The objective of the study is to assess the pattern of lymph node metastasis and to plan the extent of neck dissection accordingly. Though central neck dissection (CND) is routinely done in PTC but the indication of extent of  neck dissection is still controversial.Methods: The medical records of   86 patients with PTC  who underwent total thyroidectomy (TT) and neck dissection at Dr. B. Borooah Cancer Institute(BBCI) from January 2010 to  December 2014 were retrospectively reviewed.Results: Out of 86 patients 22 were males and 64 were females. The median age of presentation was 40.0 years. 43 out of 86 patients (50%) had cervical lymph node metastasis. Ipsilateral nodal metastasis was found in 37 patients (43.0%) and contralateral metastasis was found in only 6 patients (7.0%).Tumors with size more than 3cm had ipsilateral nodal metastasis in 21(56.7%) patients which is statistically significant (p 0.03).A strong association was found between level VI and the ipsilateral group of lymph nodes involving level II,III,IV and V.Conclusions: Majority of patients present with multiple level nodal metastasis, with the central compartment commonly involved. In view of the high incidence of metastatic lymph nodes in levels II, III, IV and level VI ,our study  supports the recommendation  for posterolateral  and anterior  neck dissection in patients with clinically positive neck  nodes and tumor with aggressive criteria

Novas raças de Fusarium oxysporum f.sp. phaseoli identificadas em Goiás e Minas Gerais, Brasil.

O objetivo deste trabalho foi verificar a variabilidade patogênica de isolados de Fop oriundos de 53 amostras coletadas em municípios de Minas Gerais e Goiás.Pôster - graduação

Thermogravimetric and reaction kinetic analysis of biomass samples from an energy plantation

The products of a Hungarian experimental plantation for energy crops were investigated. Young shoots of poplar clones (Populus x euramericana and Populus x interamericana), black locust (Robinia pseudoacacia), willow (Salix alba), and an herbaceous plant (Miscanthus sinensis) revealed unexpectedly similar thermal behavior in inert and oxidative atmospheres, as well. An 8-fold difference in the level of grinding did not result in substantial differences in the thermal decomposition. The effect of oxygen in the ambient gas was studied at low sample masses (0.2-0.4 mg) that excluded the overheating due to the high reaction heat of the combustion process. The presence of oxygen affects the decomposition from ca. 220 degreesC. Nevertheless, the extrapolated onset temperature of the hemicellulose decomposition is practically the same at 0, 5, and 21 V/V% oxygen. A group of 12 experiments, representing two grinding levels, three plant genera and four different heating programs were evaluated simultaneously by the method of least squares employing the model of independent pseudocomponents. All evaluated experiments were well described by the same set of kinetic parameters; only the parameters describing the peak area of the partial processes differed. A technique was recommended for the appropriate handling of the nonrandom errors in the simultaneous evaluation of experiment series

Prevalence of BRCA1 and BRCA2 mutations in unselected breast cancer patients from Greece

<p>Abstract</p> <p>Background</p> <p>Inheritance of a mutation in either <it>BRCA1 </it>or <it>BRCA2 </it>accounts for approximately 5% of all breast cancer cases, but varies by country. Investigations into the contribution of <it>BRCA </it>mutations to breast cancer incidence in Greece have been, for the most part, limited by small sample sizes and by the use of cases selected for their family history of cancer. The aim of the current study was to estimate <it>BRCA </it>mutation frequencies in breast cancer patients unselected for family history.</p> <p>Methods</p> <p>To do so, we enrolled 127 unselected women with breast cancer from the Alexandra Hospital in Athens, Greece, a large public hospital in the city. Mutations in <it>BRCA1 </it>and <it>BRCA2 </it>were detected using a combination of techniques and were confirmed by direct sequencing. Two large genomic deletions were sought using mutation-specific assays. A detailed family history of cancer was obtained from each patient.</p> <p>Results</p> <p>We were able to successfully complete testing on samples from 127 women. Among these, six mutations were identified (four in <it>BRCA1 </it>and two in <it>BRCA2</it>) representing 4.7% of the total or 9.5% of cases diagnosed before age forty. None of the mutation carriers had a family history of breast or ovarian cancer. Three of the four <it>BRCA1 </it>mutations were in exon 20: two were a G5331A mutation and the third was a 3.2 kb deletion. The fourth <it>BRCA1 </it>mutation was the 3819delGTAAA in exon 11. The two <it>BRCA2 </it>mutations were in exon 11 (3782del10 and 4512insT).</p> <p>Conclusions</p> <p>The G5331A mutation in <it>BRCA1 </it>appears to be a founder mutation in the Greek population.</p

Ancient DNA reveals admixture history and endogamy in the prehistoric Aegean (advance online)

The Neolithic and Bronze Ages were highly transformative periods forthe genetic history of Europe but for the Aegean—a region fundamentalto Europe’s prehistory—the biological dimensions of cultural transitionshave been elucidated only to a limited extent so far. We have analysed newlygenerated genome-wide data from 102 ancient individuals from Crete, theGreek mainland and the Aegean Islands, spanning from the Neolithic tothe Iron Age. We found that the early farmers from Crete shared the sameancestry as other contemporaneous Neolithic Aegeans. In contrast, the endof the Neolithic period and the following Early Bronze Age were marked by‘eastern’ gene flow, which was predominantly of Anatolian origin in Crete.Confirming previous findings for additional Central/Eastern Europeanancestry in the Greek mainland by the Middle Bronze Age, we additionallyshow that such genetic signatures appeared in Crete gradually from theseventeenth to twelfth centuries bc, a period when the influence of themainland over the island intensified. Biological and cultural connectednesswithin the Aegean is also supported by the finding of consanguineousendogamy practiced at high frequencies, unprecedented in the globalancient DNA record. Our results highlight the potential of archaeogenomicapproaches in the Aegean for unravelling the interplay of genetic admixture,marital and other cultural practice

Macrophages promote angiogenesis in human breast tumour spheroids in vivo

An in vivo model has been established to study the role of macrophages in the initiation of angiogenesis by human breast tumour spheroids in vivo. The extent of the angiogenic response induced by T47D spheroids implanted into the dorsal skinfold chamber in nude mice was measured in vivo and compared to that induced by spheroids infiltrated with human macrophages prior to implantation. Our results indicate that the presence of macrophages in spheroids resulted in at least a three-fold upregulation in the release of vascular endothelial growth factor (VEGF) in vitro when compared with spheroids composed only of tumour cells. The angiogenic response measured around the spheroids, 3 days after in vivo implantation, was significantly greater in the spheroids infiltrated with macrophages. The number of vessels increased (macrophages vs no macrophages 34±1.9 vs 26±2.5, P<0.01), were shorter in length (macrophages vs no macrophages 116±4.92 vs 136±6.52, P<0.008) with an increased number of junctions (macrophages vs no macrophages 14±0.93 vs 11±1.25, P<0.025) all parameters indicative of new vessel formation. This is the first study to demonstrate a role for macrophages in the initiation of tumour angiogenesis in vivo

TGF-beta receptor 2 downregulation in tumour-associated stroma worsens prognosis and high-grade tumours show more tumour-associated macrophages and lower TGF-beta1 expression in colon carcinoma: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Histological phenotype and clinical behaviour of malignant tumours are not only dependent on alterations in the epithelial cell compartment, but are affected by their interaction with inflammatory cells and tumour-associated stroma. Studies in animal models have shown influence of tumour-associated macrophages (TAM) on histological grade of differentiation in colon carcinoma. Disruption of transforming growth factor beta (TGF-beta) signalling in tumour cells is related to more aggressive clinical behaviour. Expression data of components of this pathway in tumour-associated stroma is limited.</p> <p>Methods</p> <p>Tissue micro arrays of 310 colon carcinomas from curatively resected patients in UICC stage II and III were established. In a first step we quantified amount of CD68 positive TAMs and expression of components of TGF-beta signalling (TGF-beta1, TGF-beta receptors type 1 and 2, Smad 3 and 4) in tumour and associated stroma. Further we analyzed correlation to histological and clinical parameters (histological grade of differentiation (low-grade (i.e. grade 1 and 2) vs. high-grade (i.e. grade 3 and 4)), lymph node metastasis, distant metastasis, 5 year cancer related survival) using Chi-square or Fisher's exact test, when appropriate, to compare frequencies, Kaplan-Meier method to calculate 5-year rates of distant metastases and cancer-related survival and log rank test to compare the rates of distant metastases and survival. To identify independent prognostic factors Cox regression analysis including lymph node status and grading was performed.</p> <p>Results</p> <p>High-grade tumours and those with lymph node metastases showed higher rates of TAMs and lower expression of TGF-beta1. Loss of nuclear Smad4 expression in tumor was associated with presence of lymph node metastasis, but no influence on prognosis could be demonstrated. Decrease of both TGF-beta receptors in tumour-associated stroma was associated with increased lymph node metastasis and shorter survival. Stromal TGF-beta receptor 2 expression was an independent prognostic factor for cancer related survival.</p> <p>Conclusion</p> <p>Histological phenotype and clinical behaviour of colon cancer is not only influenced by mutational incidents in tumour cells but also affected by interaction of tumour tissue with inflammatory cells like macrophages and associated stroma and TGF-beta signalling is one important part of this crosstalk. Further studies are needed to elucidate the exact mechanisms.</p

Tyrosine kinase inhibitors reprogramming immunity in renal cell carcinoma: rethinking cancer immunotherapy

Review article[Abstract] The immune system regulates angiogenesis in cancer by way of both pro- and antiangiogenic activities. A bidirectional link between angiogenesis and the immune system has been clearly demonstrated. Most antiangiogenic molecules do not inhibit only VEGF signaling pathways but also other pathways which may affect immune system. Understanding of the role of these pathways in the regulation of immunosuppressive mechanisms by way of specific inhibitors is growing. Renal cell carcinoma (RCC) is an immunogenic tumor in which angiogenesis and immunosuppression work hand in hand, and its growth is associated with impaired antitumor immunity. Given the antitumor activity of selected TKIs in metastatic RCC (mRCC), it seems relevant to assess their effect on the immune system. The confirmation that TKIs improve cell cytokine response in mRCC provides a basis for the rational combination and sequential treatment of TKIs and immunotherapy

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems