Search

Objectives To evaluate the effect of L-carnitine (LC) in combination with leucine supplementation on muscle strength and muscle hypertrophy in aged women participating in a resistance exercise training (RET) program. Design/Setting/Participants Thirty-seven out of sixty (38.3% dropout) healthy women aged 60–75 years (mean 67.6 ± 0.7 years) completed the intervention in one of three groups. One of the supplemented groups received 1 g of L-carnitine-L-tartrate in combination with 3 g of L-leucine per day (LC+L group; n = 12), and the second supplemented group received 4 g of L-leucine per day (L group; n = 13). The control group (CON group; n = 12) received no supplementation. Intervention All three groups completed the same RET protocol involving exercise sessions twice per week for 24 weeks. Measurements Before and after the experiment, participants performed isometric and isokinetic muscle strength testing on the Biodex dynamometer. The cross-sectional areas of the major knee extensors and total thigh muscles were assessed using magnetic resonance imaging. Fasting serum levels of insulin-like growth factor-1 (IGF-1), myostatin and decorin, and plasma levels of total carnitine (TC) and trimethylamine-N-oxide (TMAO) levels were measured. Results The 24-week RET significantly increased muscle strength and muscle volume, but the group and time interactions were not significant for the muscle variables analyzed. Plasma total carnitine increased only in the LC+L group (p = 0.009). LC supplementation also caused a significant increase in plasma TMAO, which was higher after the intervention in the LC+L group than in the L (p < 0.001), and CON (p = 0.005) groups. The intervention did not change plasma TMAO concentration in the L (p = 0.959) and CON (p = 0.866) groups. After the intervention serum decorin level was higher than before in both supplemented groups combined (p = 0.012), still not significantly different to post intervention CON (p = 0.231). No changes in serum IGF-1 and myostatin concentrations and no links between the changes in blood markers and muscle function or muscle volume were observed. Conclusions LC combined with leucine or leucine alone does not appear to improve the effectiveness of RET.

Alzheimer’s disease (AD) is associated with the deposition of β-amyloid in the brain. AD accounts for over 50% of cases of dementia which results from disturbances in redox homeostasis. Indeed, increased intensity of protein oxidation and nitration as well as lipid peroxidation is observed in brain areas with considerable amounts of amyloid plaques and neurofibrillary tangles. However, little is known about the oxidoreductive balance of salivary glands in AD patients. Therefore, the aim of this study was to evaluate the antioxidant barrier and oxidative/nitrosative stress biomarkers in stimulated saliva and blood of AD patients. The study was participated by 25 AD patients and 25 non-demented controls without neurological diseases or cognitive impairment, matched by age and gender to the study group. The number of patients was determined based on a previous pilot study (test power = 0.9). We found a significant decrease in the activity of erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx), increased activity of catalase (CAT) and reduced concentration of plasma non-enzymatic antioxidants (uric acid, UA and reduced glutathione, GSH). In contrast, in the stimulated saliva of AD patients we observed significantly decreased activity of all antioxidant enzymes (SOD, CAT and GPx) as well as concentration of GSH compared to the control group. The content of lipid (malondialdehyde, MDA) and protein (advanced oxidation protein products, AOPP; advanced glycation end-products, AGE) oxidation products as well as biomarkers of nitrosative stress (peroxynitrite, nitrotyrosine) was significantly higher in both saliva and plasma of AD patients compared to the controls. In AD patients, we also observed a considerable decrease in stimulated saliva secretion and salivary total protein content, and an increase in salivary β-amyloid concentration. In conclusion, AD results in redox imbalance towards oxidative reactions, both at the level of the oral cavity and the entire body. General redox balance disturbances do not coincide with salivary redox balance disturbances. Reduction in stimulated saliva secretion in AD patients reflects secretory dysfunction of the parotid glands.

Purpose. This study is aimed at evaluating the impact of the craniofacial structure and occlusal conditions on the position of the articular heads of the mandibular condyles in the maximum intercuspal position (MIP) and comparing the centric relation (CR) and MIP of the mandibular condyles prior to orthodontic treatment. Methods. The studied group consisted of 33 women and 15 men (median age of 17.75 years). Contact points of opposing teeth in the MIP were assessed by hand-held casts. Condylar displacement (CD) in three spatial planes on both sides was measured on models mounted in an articulator using a mandibular position indicator (MPI). Patients were divided into groups according to craniofacial structures (vertical and horizontal growth directions). The Mann-Whitney, Kruskal-Wallis, post hoc Dwass-Steel-Critchlow-Fligner, and Pearson’sχ2independence tests as well as Spearman’s nonparametric correlations were used in the statistical analyses. Results. Within the limitations of this study, no statistically significant correlation of CD with certain cephalometric measurements from a lateral cephalometric radiograph (ANB, SN-ML, and SGo/NMe) was observed. Correlation, however, was found between condylar displacement in the transverse axis and the mandibular plane angle SN-ML (p=0.033) and also between condylar displacement in the anteroposterior axis and a midline shift of the mandible (p=0.041). The results revealed a relationship between Angle’s classification of molar position on the right side and anteroposterior CD values (p=0.006). Conclusions. Cephalometric measurements cannot be used to predict CD at the level of the condyles. Analysis of occlusal conditions of models mounted in an articulator is desirable for patients with Angle’s class I and lower jaw asymmetry.

There is evidence for ketamine use in treatment-resistant depression (TRD). Several safety and tolerability concerns arise regarding adverse drug reactions and specific subpopulations. This paper aims to investigate the relationship between dissociative and psychometric measures in course of intravenous ketamine treatment in TRD inpatients with major depressive disorder and bipolar disorder. This study result represents safety data in a population of 49 inpatients with major depressive disorder and bipolar disorder subjects receiving eight 0.5 mg/kg of ketamine intravenous infusions, with a duration of 40 min each, as an add-on treatment to standard-of-care pharmacotherapy, registered in the naturalistic observational protocol of the tertiary reference unit for mood disorders ({"type":"clinical-trial","attrs":{"text":"NCT04226963","term_id":"NCT04226963"}}NCT04226963). The safety psychometrics assessed dissociation and psychomimetic symptomatology with the Clinician-Administered Dissociative States Scale (CADSS) the Brief Psychiatric Rating Scale (BPRS). The significant differences in CADSS scores between measurements in course of the treatment were observed (P = .003). No significant differences between BPRS measurements were made after infusions. In each case, both BPRS and CADSS values dropped to the “absent” level within 1 hour from the infusion. Neither CADSS nor BPRS scores were associated with the treatment outcome. The study demonstrates a good safety profile of intravenous ketamine as an add-on intervention to current psychotropic medication in TRD. The abatement of dissociation was observed in time with no sequelae nor harm. The study provides no support for the association between dissociation and treatment outcome. This study may be underpowered due to the small sample size. The protocol was defined as a study on acute depressive symptomatology without blinding.

l-carnitine supplementation has been used for cardiovascular health protection for a long time. Recently, trimethylamine-N-oxide (TMAO), which is an end product of l-carnitine metabolism via the activity of microbiota, has been identified as a cardiovascular disease (CVD) biomarker. The aim of this study was to assess the effect of 6 months of l-carnitine supplementation in a group of aged women engaged in a regular physical training. Platelet mitochondrial DNA methylation, an emerging and innovative biomarker, lipid profile and TMAO levels have been measured. TMAO increased after l-carnitine supplementation (before 344.3 &plusmn, 129.8 ng/mL vs. after 2216.8 &plusmn, 1869.0 ng/mL, n = 9, paired t-test, p = 0.02). No significant effects on TMAO were exerted by training alone (n = 9) or by l-leucine supplementation (n = 12). TMAO levels after 6 months of l-carnitine supplementation were associated with higher low-density lipoprotein-cholesterol (LDL-c) (Spearman Rho = 0.518, p = 0.003) and total cholesterol (TC) (Spearman Rho = 0.407, p = 0.026) levels. l-carnitine supplementation increased D-loop methylation in platelets (+6.63%, paired t-test, p = 0.005). D-loop methylation was not directly correlated to the TMAO augmentation observed in the supplemented group, but its increase inversely correlated with TC (Pearson coefficient = &minus, 0.529, p = 0.029) and LDL-c (Pearson coefficient = &minus, 0.439, p = 0.048). This evidence supports the hypothesis that the correlation between l-carnitine, TMAO and atherosclerosis might be more complex than already postulated, and the alteration of mitochondrial DNA (mtDNA) methylation in platelets could be involved in the pathogenesis of this multifactorial disease.

Background: The evidence accumulates that the response to acetazolamide test is delayed on the ipsilateral side to stenosis. However, the effect of acetazolamide beyond 30 min after acetazolamide administration remains unknown. The aim of this study was to assess the diameters of anterior cerebral arteries (ACAs), middle cerebral arteries (MCAs) and posterior cerebral arteries (PCAs) before and 60 min after the acetazolamide test. Materials and methods: Seventeen patients with carotid artery stenosis ≥ 90% on the ipsilateral side and ≤ 50% on the contralateral side were enrolled into the study. Diagnosis was based on ultrasonography examination and was confirmed using digital subtractive angiography. In all patients, two computed tomography angiography examinations were carried out; the first was performed before the acetazolamide administration, while the second one was carried out 60 min after injections. Results: In response to the acetazolamide test: PCA diameter diminished in both ipsi- and contra-lateral side to stenosis (from 1.31 to 1.24 mm and from 1.23 to 1.15 mm, respectively), ACA and MCA decreased in the contralateral side to the stenosis (from 1.33 to 1.26 mm and from 2.75 to 2.66 mm, respectively), ACA and MCA increased in the ipsilateral side to the stenosis (from 1.29 to 1.46 mm and from 2.77 to 2.96 mm, respectively). All changes were statistically significant. Conclusions: There were significant differences in reactivity to acetazolamide challenge between the internal carotid artery (ICA) and vertebrobasilar circulation in patients suffering from chronic carotid artery stenosis. Within the ICA territory, ACA and MCA responses vary in the affected and not affected side.

Aim: The study was aimed at investigation of several gene variants of folate pathway enzymes for their potential association with methotrexate (MTX) treatment response in patients with rheumatoid arthritis. Patients & methods: Four hundred and twenty two Caucasian patients were classified as good or poor responders, and subsequently genotyped for common SNPs in DHFR, FPGS and ATIC genes. Results: No significant differences were observed in case of DHFR and FGPS SNPs. As for ATIC rs2372536 (Thr116Ser), GG minor genotype was significantly associated with good response to MTX (OR: 2.40; 95% CI: 1.30–4.42; p = 0.005), which was confirmed by multivariate analysis. Conclusion: The results of the study suggest that ATIC missense rs2372536 SNP may influence response to MTX therapy in rheumatoid arthritis patients.

Purpose The aim of this study was to check the pro-apoptotic mechanism of prosthetic reconstruction on epithelial cells of the oral mucosa. Patients and methods The research was carried out on the saliva of healthy patients using prostheses. The sample swabs were stained using the May-Grunwald-Giemsa method and processed by immunohistochemistry for nuclear factor kappa B (NF-κB; p65) and caspase-3. Western blots were used to detect caspase-3, NF-κB, p53 and COX-2 expression. Results We found an increased expression of caspase-3, NF-κB and p53 in the oral epithelial cells of patients using prosthetic restorations compared to the subjects from the control group. No differences in COX-2 expression were found between the groups. The strongest immunoreactivity and expression of caspase-3, NF-κB and p53 were observed in patients using full prosthesis for less than two years. Conclusions The results of the conducted research indicate that prosthetic restorations may affect the process of apoptosis of oral mucosa epithelial cells. Lack of difference in expression of COX-2 in the saliva of the studied patients suggests that apoptosis is not caused by inflammatory factors.

In this study we hypothesized that the alleviation of neurological symptoms long after internal carotid artery (ICA) stenting may be related to sustained improvement of cerebral perfusion. Thirty-four subjects (F/M; 15/19) with70% stenosis of a single internal carotid artery and neurological symptoms, who underwent a carotid artery stenting procedure, were studied. Brain computed tomography perfusion (CTP) imaging was performed before and 3 years after ICA stenting. The following relative variables were compared: cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), time to peak (rTTP), and permeability surface area product (rPS). A survey also was conducted to compare the patients' clinical symptoms. Overall, we found that a trend toward rMTT decline was the only persisting change after ICA stenting. We then stratified the patients into the subgroups of2%, 2-5%, and 5% rMTT decline and found that those with a rMTT decline2% reported a prominent reduction in subjective clinical symptoms such as headache, dizziness, tinnitus, blurred vision, transient blindness, a sense of gravity of the head, and pain in the eyeballs. We conclude that a shortened mean rMTT, likely reflecting improved cerebral microcirculation, underlies the improvement of neurological symptoms in patients with ICA stenosis.

Objectives: We tested the hypothesis that computed tomography (CT) perfusion markers of cerebral microcirculation would improve 36 months after internal carotid artery stenting for symptomatic carotid stenosis while results obtained 6–8 weeks after the stenting procedure would yield a predictive value. Methods: We recruited consecutive eligible patients with >70% symptomatic carotid stenosis with a complete circle of Willis and normal vertebral arteries to the observational cohort study. We detected changes in the cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP) and permeability surface area-product (PS) before and after carotid stenting. We have also compared the absolute differences in the ipsilateral and contralateral CT perfusion markers before and after stenting. The search for regression models of “36 months after stenting” results was based on a stepwise analysis with bidirectional elimination method. Results: A total of 34 patients completed the 36 months follow-up (15 females, mean age of 69.68±S.D. 7.61 years). At 36 months after stenting, the absolute values for CT perfusion markers had improved: CBF (ipsilateral: +7.76%, contralateral: +0.95%); CBV (ipsilateral: +5.13%, contralateral: +3.00%); MTT (ipsilateral: –12.90%; contralateral: –5.63%); TTP (ipsilateral: –2.10%, contralateral: –4.73%) and PS (ipsilateral: –35.21%, contralateral: –35.45%). MTT assessed 6–8 weeks after stenting predicted the MTT value 36 months after stenting (ipsilateral: R2=0.867, contralateral R2=0.688). Conclusions: We have demonstrated improvements in CT perfusion markers of cerebral microcirculation health that persist for at least 3 years after carotid artery stenting in symptomatic patients. MTT assessed 6–8 weeks after stenting yields a predictive value.

Transpedicular stabilization is a frequently used spinal surgery for fractures, degenerative changes, or neoplastic processes. Improper screw fixation may cause substantial vascular or neurological complications. This study seeks to define detailed morphometric measurements of the pedicle (height, width, and surface area) in the aspects of screw length and girth selection and the trajectory of its implantation, i.e., sagittal and transverse angle of placement. The study was based on CT examinations of 100 Caucasian patients (51 women and 49 men) aged 27-75 with no anatomical, degenerative, or post-traumatic spine changes. The results were stratified by gender and body side, and they were counter compared with the available literature database. Pedicle height decreased from L1 to L4, ranging from 15.9 to 13.3 mm. Pedicle width increased from L1 to L5, extending from 6.1 to 13.2 mm. Pedicle surface area increased from L1 to L5, ranging from 63 to 140 mm

Radiological assessment of treatment effectiveness of guided bone regeneration (GBR) method in postresectal and postcystal bone loss cases, observed for one year. Group of 25 patients (17 females and 8 males) who underwent root resection with cystectomy were evaluated. The following combination therapy of intraosseous deficits was used, consisting of bone augmentation with xenogenic material together with covering regenerative membranes and tight wound closure. The bone regeneration process was estimated, comparing the images taken on the day of the surgery and 12 months later, by means of Kodak RVG 6100 digital radiography set. The interpretation of the radiovisiographic image depends on the evaluation ability of the eye looking at it, which leaves a large margin of uncertainty. So, several texture analysis techniques were developed and used sequentially on the radiographic image. For each method, the results were the mean from the 25 images. These methods compute the fractal dimension ( D ), each one having its own theoretic basis. We used five techniques for calculating fractal dimension: power spectral density method, triangular prism surface area method, blanket method, intensity difference scaling method and variogram analysis. Our study showed a decrease of fractal dimension during the healing process after bone loss. We also found evidence that various methods of calculating fractal dimension give different results. During the healing process after bone loss, the surfaces of radiographic images became smooth. The result obtained show that our findings may be of great importance for diagnostic purpose.

This study seeks to define the role of predictive values of the motor speed, inhibition control, and fluid and crystallized intelligence in estimating the cortical thickness in healthy elderly. Forty-six older healthy subjects (37 women, 9 men) over 60 years of age were included in the study. The participants were examined on 3.0 T MRI scanners. The protocol included standard anatomical sequences, to exclude brain pathology, and a high-resolution T1-weighted sequence used to estimate the cortical thickness. The neuropsychological protocol included fluid intelligence assessment (Raven Progressive Matrices), crystalized intelligence assessment (information or vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R)), and executive functioning (Color Traits Test). The findings unraveled several interdependencies. The higher the intelligence, the thicker was the grey matter in nine regions of both hemispheres, but also some paradoxical reversed associations were found in four areas; all of them were localized along different sections of the cingulate gyrus in both hemispheres. An inverse association was found between crystallized intelligence and the thickness of the pars opecularis of the right hemisphere. The better the executive functioning, the thicker was the grey matter of a given region. The better the motor performance, the thicker was the grey matter of the rostral middle frontal area of the left hemisphere and the lingual gyrus of both hemispheres. In conclusion, the associations unraveled demonstrate that the neural mechanisms underlying healthy aging are complex and heterogenic across different cognitive domains and neuroanatomical regions. No brain aging theory seems to provide a suitable interpretative framework for all the results. A novel, more integrative approach to the brain aging should be considered.

The aim of this study was to assess regional perfusion at baseline and regional cerebrovascular resistance (CVR) to delayed acetazolamide challenge in subjects with chronic carotid artery stenosis.Sixteen patients (ten males) aged 70.94±7.71 with carotid artery stenosis ≥90% on the ipsilateral side and ≤50% on the contralateral side were enrolled into the study. In all patients, two computed tomography perfusion examinations were carried out; the first was performed before acetazolamide administration and the second 60 minutes after injection.The differences between mean values were examined by paired two-sample t-test and alternative nonparametric Wilcoxon’s test. Normality assumption was examined using W Shapiro-Wilk test.The lowest resting-state cerebral blood flow (CBF) was observed in white matter (ipsilateral side: 18.4±6.2; contralateral side: 19.3±6.6) and brainstem (ipsilateral side: 27.8±8.5; contralateral side: 29.1±10.8). Grey matter (cerebral cortex) resting state CBF was below the normal value for subjects of this age: frontal lobe – ipsilateral side: 30.4±7.0, contralateral side: 33.7±7.1; parietal lobe – ipsilateral side: 36.4±11.3, contralateral side: 42.7±9.9; temporal lobe – ipsilateral side: 32.5±8.6, contralateral side: 39.4±10.8; occipital lobe – ipsilateral side: 24.0±6.0, contralateral side: 26.4±6.6). The highest resting state CBF was observed in the insula (ipsilateral side: 49.2±17.4; contralateral side: 55.3±18.4). A relatively high resting state CBF was also recorded in the thalamus (ipsilateral side: 39.7±16.9; contralateral side: 41.7±14.1) and cerebellum (ipsilateral side: 41.4±12.2; contralateral side: 38.1±11.3). The highest CVR was observed in temporal lobe cortex (ipsilateral side: +27.1%; contralateral side: +26.1%) and cerebellum (ipsilateral side: +27.0%; contralateral side: +34.6%). The lowest CVR was recorded in brain stem (ipsilateral side: +20.2%; contralateral side: +22.2%) and white matter (ipsilateral side: +18.1%; contralateral side: +18.3%). All CBF values were provided in milliliters of blood per minute per 100 g of brain tissue [ml/100g/min]. Resting state circulation in subjects with carotid artery stenosis is low in all analysed structures with the exception of insula and cerebellum. Acetazolamide challenge yields relatively uniform response in both hemispheres in the investigated population.Grey matter is more reactive to acetazolamide challenge than white matter or brainstem.

Failure of the blood-brain barrier (BBB) is a critical event in the development and progression of diseases such as acute ischemic stroke, chronic ischemia or small vessels disease that affect the central nervous system. It is not known whether BBB breakdown in subjects with chronic carotid artery stenosis can be restrained with postoperative recovery of cerebral perfusion. The aim of the study was to assess the short-term effect of internal carotid artery stenting on basic perfusion parameters and permeability surface area-product (PS) in such a population. Forty subjects (23 males) with stenosis of >70% within a single internal carotid artery and neurological symptoms who underwent a carotid artery stenting procedure were investigated. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after surgery: global cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP) and PS. PS acquired by CTP is used to measure the permeability of the BBB to contrast material. In all baseline cases, the CBF and CBV values were low, while MTT and TTP were high on both the ipsi- and contralateral sides compared to reference values. PS was approximately twice the normal value. CBF was higher (+6.14%), while MTT was lower (−9.34%) on the contralateral than on the ipsilateral side. All perfusion parameters improved after stenting on both the ipsilateral (CBF +22.66%; CBV +18.98%; MTT −16.09%, TTP −7.62%) and contralateral (CBF +22.27%, CBV +19.72%, MTT −14.65%, TTP −7.46%) sides. PS decreased by almost half: ipsilateral −48.11%, contralateral −45.19%. The decline in BBB permeability was symmetrical on the ipsi- and contralateral sides to the stenosis. Augmented BBB permeability can be controlled by surgical intervention in humans.

Background: The aim of this study was to analyse the morphometry of the intracranial segment of the vertebral artery in the context of clinical usefulness. The results were compared with published data available in full-text archived medical journals. Materials and methods: More than 100 digital subtraction angiography (DSA) and 3-dimensional (3D) angio-computed tomography (CT) examinations were used to measure the following parameters: the whole and partial length of V4 in characteristic anatomical points, the diameter in three places (on the level of foramen magnum, in point of exit to the posterior inferior cerebellar artery, and in the vertebro-basilar junction), the angle of connection to the vertebral arteries, and all anatomical variations including fenestration, duplication, dolichoectasia or absent artery. Results: The left V4 section was predominant over the right artery, which is manifested by length, width, cases of ectasia and fewer cases of hypoplasia. The incidences of V4 ectasia were identified more often than those documented in the accessible literature, and they were found in the natural location of formation of saccular aneurysms. Conclusions: The presented knowledge of anatomical variation and abnormali­ties of vertebral circulation can improve the accuracy and “safety” of the surgical procedures in this region, help to determine the range of surgical approach and avoid associated complications. The radiological examinations using 3D CT, DSA reveal unlimited observation of anatomical structures in contrast to studies based on cadavers, and can complement the morphometry in anatomical preparations.

Metastatic lesions within the ovary constitute a serious diagnostic problem in daily practice. We present an interesting case of Krukenberg tumor in a woman 13 years after partial gastrectomy due to stomach cancer. Our case confirms that every woman with history of cancer should remain under gynecological control. It is important due to a high risk of metastatic changes localized in the ovaries, regardless of the time elapsed since the diagnosis of the primary tumor

Background Meniscus extrusion is a serious and relatively frequent clinical problem. For this reason the role of different risk factors for this pathology is still the subject of debate. The goal of this study was to verify the results of previous theoretical work, based on the mathematical models, regarding a relationship between the cross-section shape of the meniscus and the risk of its extrusion. Materials and Methods Knee MRI examination was performed in 77 subjects (43 men and 34 women), mean age 34.99 years (range: 18–49 years), complaining of knee pain. Patients with osteoarthritic changes (grade 3 and 4 to Kellgren classification), varus or valgus deformity and past injuries of the knee were excluded from the study. A 3-Tesla MR device was used to study the relationship between the shape of the lateral meniscus (using slope angle, meniscus-cartilage height and meniscus-bone angle) and the risk of extrusion. Results Analysis revealed that with values of slope angle and meniscus-bone angle increasing by one degree, the risk of meniscus extrusion raises by 1.157 and 1.078 respectively. Also, an increase in meniscus-cartilage height by 1 mm significantly elevates the risk of extrusion. At the same time it was demonstrated that for meniscus-bone angle values over 42 degrees and slope angle over 37 degrees the risk of extrusion increases significantly. Conclusions This was the first study to demonstrate a tight correlation between slope angle, meniscus-bone angle and meniscus-cartilage height values in the assessment of the risk of lateral meniscus extrusion. Insertion of the above parameters to the radiological assessment of the knee joint allows identification of patients characterized by an elevated risk of development of this pathology.

Purpose This is the first report of a rare genetic tooth and nail syndrome (TNS) diagnosed in a 14-year-old Caucasian girl with a complete absence of the permanent dentition and, additionally, reduced total and lumbar spine bone mineral density (BMD). This coincidence suggests a new clinical manifestation of the disorder in which genetic factors and/or shared mechanisms may be responsible for the deterioration of the stomatognathic system, anodontia, nail phenotype and osteopenia. Low bone mass appears to be a new component of the syndrome. There is a rationale for bone densitometry scans assuming that patients with TNS may have an increased risk of osteopenia. Reduced BMD and, possibly, impaired bone quality and strength may produce difficulties or even exclude such patients from future treatment with dental implants.

The purpose of the study was to assess the effect of gender and age of patients with impacted permanent maxillary canines on complications in the course of tooth transposition.The study material included files of 82 patients with a diagnosis of unilateral or bilateral impaction of 102 permanent maxillary canines. The study group consisted of 65 female and 17 male subjects, aged 8.5-39 years (mean 14.5 years) divided into four age groups: group I--patients under 12, group II--12.0-13.9 years, group III--14.0-15.9 years and group IV--patients at the age of 16 and older.In the study population, the impacted teeth showed the following locations: palatal (67.64%), vestibular (19.60%) and alveolar (12.74%). Spontaneous resorption caused by abnormal tooth position was observed in 5 (4.9%) permanent maxillary lateral incisors. In 4 cases, the resorption was bilateral and all the five cases were recorded in group III. In group IV, one patient had alveolar process atrophy and severe resorption, while another one showed ankylosis of a permanent canine. Extraction of palatally impacted canines was done in 3.92% of cases. Complications were noted in girls and referred to 5.58% of the study cases.Orthodontic movement of the impacted teeth to the dental arch may result in complications. However, because of the major significance of the upper canine which is responsible for the behaviour of the frontal triad, surgical-orthodontic treatment should be undertaken to improve occlusion and the aesthetic look of patients. Thus, any case of the ectopic canine requires observation and proper choice of radiological diagnostics.

The aim of the study was to assess the effect of orthodontic movement of the impacted canines after surgical exposure and alignment on the periodontal status of the transpositioned and adjacent teeth as well as to compare certain parameters with those of spontaneously erupted teeth.Twenty-four patients (mean age 18.4 +/- 3.66) with unilaterally impacted 24 canines were enrolled in the study. The following parameters were assessed: pocket depth (PD), clinical attachment level (CAL), platelet index (PI) of Silness and Löe, and modified sulcus bleeding index (SBI). Optic density of the alveolar bone along the root surface of the aligned canine was analysed based on digital radiological images made with the right angle technique. Control group consisted of spontaneously erupted teeth.In comparison to the control group, in the orthodonticaly treated group PD was found to increase on the mesial buccal and palatal surfaces of the first premolar (p0.003, p0.04), on the treated side; on the distal buccal (p0.01), mesial buccal (p0.0005), mesial palatal (p0.02) and distal palatal surfaces of the canine (p0.02); and on the distal buccal (p0.04) and distal palatal surfaces of the lateral incisor (p0.048). CAL was statistically significant on the mesio-buccal and mesio-palatal surfaces of the aligned canine (p0.02). PI was statistically insignificant, while SBI values at the aligned tooth were statistically significant (p0.0004). Positive correlation was found between treatment duration and distance to the occlusal plane (d) expressed by the correlation coefficient r = 0.49 (p0.02). No relationship was observed between bone density within the canine alignment zone and the control, and there was no link between the method of treatment and periodontal status, either.The alignment of the impacted permanent maxillary canines poses a risk of periodontal deterioration. Patients subjected to surgical-orthodontic treatment require periodic periodontal follow-ups.

PURPOSE: The purpose of the study was to assess the responses of pial artery pulsation (cc-TQ) and subarachnoid width (sas-TQ) to acetazolamide challenge in patients with chronic carotid artery stenosis and relate these responses to changes in peak systolic velocity (PSV), cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to peak response (TTP). METHODS: Fifteen patients with carotid artery stenosis ≥ 90% on the ipsilateral side and

The impact of coverage size on global cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to peak (TTP) parameters has not been investigated in patients with chronic carotid artery stenosis.63 patients with stenosis of70% within a single internal carotid artery and neurological symptoms were randomly assigned to two well-matched groups. Differences in CT perfusion scan over a 4 cm or 8 cm range of the brain were compared between the two groups.The CBF and CBV values were higher in the 4 cm coverage size than in the 8 cm coverage size (by 14.7 and 10.7% on the ipsilateral side and 17.2 and 7.8% on the contralateral side, respectively; all p 0.001). The MTT value was higher in the 4 cm coverage size than in the 8 cm coverage size on the ipsilateral side (9.6%; p 0.001). There was no difference between MTT values in the contralateral size. There were no differences between TTP values on the ipsilateral and contralateral sides. The relative indices rMTT and rTTP were higher in the 4 cm coverage size than in the 8 cm coverage size (8.2%, p 0.001, and 1.1%, p 0.005, respectively).Absolute CBF and CBV values and relative rMTT and rTTP indices in patients with low CBF and low CBV are highly dependent on coverage size. We recommend using a 4 cm coverage size to assess global cerebral perfusion parameters owing to better accuracy and quicker post-processing.To the best of our knowledge, this is the first article to compare the influence of 4 cm vs 8 cm coverage size on cerebral perfusion parameters such as CBF, CBV, MTT and TTP in subjects with chronic carotid artery stenosis.

Background Cavernous hemangiomas are the most frequent neoplasms of the liver and in routine clinical practice they often need to be differentiated from malignant tumors and other benign focal lesions. The purpose of this study is to evaluate whether diagnostic accuracy of magnetic resonance imaging (MRI) of hepatic hemangiomas, showing atypical pattern on US, improves with the use of Gd-BOPTA in comparison with contrast-enhanced multi-phase computed tomography (CT). Methods 178 consecutive patients with ambiguous hepatic masses showing atypical hyperechoic pattern on grey-scale US, underwent unenhanced and contrast-enhanced multi-phase multi-detector CT and MR (1.5T) with the use of liver-specific contrast medium gadobenate dimeglumine (Gd-BOPTA). After intravenous contrast administration arterial (HAP), venous-portal (PVP), equilibrium phases (EP) both in CT and MR and additionally hepatobiliary phase (HBP) in MR were obtained. 398 lesions have been detected including 99 hemangiomas and 299 other lesions. Results In non-enhanced MDCT examination detection of hemangiomas was characterized by sensitivity of 76%, specificity of 90%, PPV of 71%, NPV of 92% and accuracy of 86%. Non-enhanced MR examination showed sensitivity of 98%, specificity of 99%, PPV of 99%, NPV of 99% and accuracy of 99%. After intravenous administration of contrast medium in MR the mentioned above parameters did not increase significantly. Conclusion Gd-BOPTA-enhanced MR in comparison with unenhanced MRI does not improve diagnostic accuracy in discriminating hemangiomas that show non-specific appearance in ultrasound examination. Unenhanced MR as a method of choice should directly follow US in course of diagnostic algorithm in differentiation of hemangiomas from other liver tumors.

Considering nickel release from fixed orthodontic appliances, determination of the relationship between the clinical status of the mouth, IgE level and treatment duration in orthodontic patients seems to be advisable.Twenty-one patients with symptoms of nickel hypersensitivity observed during treatment with fixed orthodontic appliances were separated from a group of 50 subjects, aged 11-33 years, undergoing orthodontic treatment for malocclusion. The patients were divided into two subgroups PgA and PgB.The mean IgE level in PgA was 39.20 IU/ml and in PgB 210.61 IU/ml. In PgA, the majority of patients were wearing ear-rings (8/10), but not in PgB (4/11). The mean treatment duration in PgA was 21.3 +/- 4.83 months, while in PgB 14.4 +/- 2.84. There were no statistically significant differences in the symptoms indicating stomatitis between the groups of patients subjected to treatment with intra-oral appliances.The immunologic profile of the patient plays a key role in the choice of the type of appliance used to treat abnormalities of the masticatory organ. Determination of IgE is necessary in the case of allergy-positive history.

In recent years, many reports have focused on clinical changes in the oral cavity of orthodontic patients, manifested in general inflammation of the mucosa. In order to better understand histopathological alterations in the mouth and the use of easily available diagnostic material, we decided to assess the morphology of salivary cells at different time points of treatment with orthodontic appliances.The study material included non-stimulated saliva obtained from 21 orthodontic patients and 11 healthy secondary school students (controls). After fixation in 96% ethanol the smears were stained with PAS + hematoxylin or H+E, and using the methods of May-Grünwald-Giemsa and Feulgen.As revealed by the histopathological examinations of saliva smears, patients treated with intra-oral fixed orthodontic appliances showed morphological changes in oral epithelial cells and in the number of leukocytes as compared to the control group. The changes were most pronounced in the first months of treatment.The preliminary data indicate that orthodontic patients develop changes in the composition and morphology of salivary cells, the intensity of which depends on the time of exposure to the appliance.

It has been showed that tryptophan (TRP) degradation has been linked to modulation of cancer cell proliferation. The aim of our study was to estimate the concentration of TRP and its derivatives, such as anthranilic (AA) and kynurenic acid (KYNA) in plasma, saliva, squamous cell carcinoma (SCC) tissues and healthy oral mucosa in patients with oral SCC.The study was performed on plasma, non-stimulated, mixed saliva and squamous cell carcinoma tissues and healthy oral mucosa in patients with oral SCC. The concentration of TRP and its metabolites were determined by high-performance liquid chromatography (HPLC).In plasma the concentration of TRP was 33.73 +/- 2.52 microM, of KYNA was 26.97 +/- 5.35 nM and of AA was 32.40 +/- 2.30 nM. In saliva the concentration of TRP was 3.81 +/- 0.62 microM, of KYNA was 8.06 +/- 1.86 nM and of AA was 20.41 +/- 10.77 nM. In cancer tissues the levels of TRP (30.21 +/- 5.88 microM), KYNA (15.85 +/- 1 .82 nM) and AA (265.32 +/- 1 51.45 nM) were higher in respect to the concentration of TRP (13.28 +/- 0.62 microM), KYNA (12.75 +/- 2.28 nM) and AA (31.68 +/- 8.89 nM) in normal tissues. The increase in the content of TRP, KYNA and AA in cancer tissues reached 127.48 +/- 5.95%, 24.31 +/- 4.35% and 737.50 +/- 206.96%, respectively.Our study has demonstrated the change of TPR metabolism, which is reflected by the increase TRP, AA and KYNA concentrations in patients with oral squamous cell carcinoma. We can suppose that these substances may be one of many factors responsible for cancer development.

Anthranilic acid is an important, the aromatic intermediate in the degradation of tryptophan in kynurenine pathway. This compound plays an important role in the regulation of immunological processes as well shows antibacterial activity. The aim of our study was to estimate the concentration of anthranilic acid in saliva of young patients with orthodontic apparatus. We also assessed correlation between saliva anthranilic acid concentrations and time of orthodontic treatment. For the first time we have demonstrated the enhanced concentration of anthranilic acid in saliva of young orthodontic appliances.The study was performed on non-stimulated, mixed saliva of patients with orthodontic appliances. The concentration of anthranilic acid and was determined by high-performance liquid chromatography.The concentration of anthranilic acid was significantly higher in orthodontic patients (p = 0.043) in comparison to healthy volunteers. The mean time of orthodontic treatment was 15.0 +/- 2.03 months. We did not observe existence of correlation between anthranilic acid concentration in saliva and time of orthodontic treatment (r = -0.250; p = 0.517).These results might indicate that anthranilic acid can be one of many factors initiating of periodontal disease in orthodontic appliances.

The aim of the study was to evaluate the dependence of gingival recession, malocclusion and factors that may lead to recessions of the gingiva in patients applying for orthodontical treatment.The study involved 52 randomly selected patients treated with fixed appliances due to occlusal irregularities and dental abnormalities. Data obtained from the examination and selected parameters from cephalometric analysis were placed in a chart including ANB skeletal class and Wits parameter, lower incisor position IMPA, dental abnormalities, extractions due to orthodontical indications and recession etiopathic factors. Statistical analysis of obtained data was conducted using variance analysis. Statistically significant were assumed those calculations for which value of significance level por = 0.05.Recession was observed in 18 patients of the 52 examined. Skeletal I class was found in 11 patients (61.12%) and in 8 cases Wits parameter corresponded with skeletal class III (44.4%). Among the patients examined normal incisor inclination was observed in 6 patients (33.33%), whereas 12 cases revealed inclination irregularities (66.66%). Clinical examination disclosed dental defects in 13 patients (72.22%) and in 12 cases recession etiopathic factors were recognized (66.66%). Statistically significant differences between periodontal biotype and gingival recession of 43, 31, 33 teeth were estimated.Anatomical factors, malocclusion and dental irregularities were fund to be the main cause of the single and/or multiple recessions. Patients applying for orthodontic treatment due to occlusal abnormalities should remain under particular control in case of symptoms suggesting the incidence of recession, particularly when recessions are already present.

Intra-oral fixed orthodontic appliances, so frequently used in the treatment of malocclusions, may cause pathomorphological changes in the mouth and can be a potential source of antigen stimulation. Therefore, the aim of the current study was to assess the changes in salivary cells of orthodontically treated allergic patients.The study material was the non-stimulated saliva samples collected from 28 allergic patients subjected to orthodontic treatment with intra-oral fixed appliances and from 11 healthy secondary school students (controls). After fixation in 96% ethanol, saliva smears were stained with PAS + hematoxylin or H+E, and using the methods of May-Grünwald-Giemsa and Feulgen. The microscopic analysis was made of oral epithelial cells and inflow elements, with regard to their shape, size, the nucleus-to-cytoplasm ratio and nuclear chromatin condensation.The results of preliminary investigations indicate that allergic patients with fixed orthodontic appliances exhibit changes in the morphology and composition of salivary cells as compared to control patients. Differences in the morphological picture were most pronounced in the first months of orthodontic treatment.It was shown that the number and morphology of salivary cells in allergic patients altered in response to ions released from dental alloys. Thus, saliva can be used as diagnostic material.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting various tissues and organs. In the studies on SLE etiopathogenesis, a potential role of genetically determined impairment of xenobiotic metabolism has been emphasized. N-acetyltransferase 2 enzyme (NAT2) exhibits gene polymorphism and the acetylation rate with NAT2 involvement varies from person to person. The study on acetylation phenotype was carried out using isonicotinic acid hydrazide (isoniazid) as a model drug, while NAT2 alleles were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. Among patients with SLE, NAT2*4/NAT2*6 and NAT2*5/NAT2*5 genotypes occurred most frequently, while NAT2*4/NAT2*6 and NAT2*5/NAT2*6 prevailed in the control group. The concordance of 96.8% was achieved between acetylation phenotype and NAT2 genotype in the group of SLE patients studied.Acetylation polymorphism appears not to be an important risk factor in SLE.

With a view to determining the frequency of contact allergy in children, a group of 100 subjects 5 to 15 years of age with various dermatoses was examined. The study group included children with allergic dermatoses (atopic dermatitis, eczema, and others) as well as nonallergic skin diseases (alopecia areata, psoriasis, vitiligo). The frequency of contact allergy occurrence in the individual groups has been determined. Contact allergy occurred the most frequently in children with various forms of eczema (60 percent), the least frequently in those with nonallergic dermatoses (32 percent). Children with eczema most often displayed a polyvalent allergy. Most frequently, positive patch test reactions occurred with potassium dichromate (in 21 percent of children), with cobalt chloride (in 11 percent), and with neomycin sulfate (in 10 percent).

Purpose The purpose of the study was to: (1) evaluate the subarachnoid space (SAS) width and pial artery pulsation in both hemispheres, and (2) directly compare magnetic resonance imaging (MRI) to near-infrared transillumination/backscattering sounding (NIR-T/BSS) measurements of SAS width changes in healthy volunteers. Methods The study was performed on three separate groups of volunteers, consisting in total of 62 subjects (33 women and 29 men) aged from 16 to 39 years. SAS width was assessed by MRI and NIR-T/BSS, and pial artery pulsation by NIR-T/BSS. Results In NIR-T/BSS, the right frontal SAS was 9.1% wider than the left (p

This work reports on the skin diseases which occur among the workers of the ceramic industry. The most frequently observed diseases were: dermatomycosis, eczema as a result of wear, and allergic diseases. Nickel, and also cobalt, turpentine, paraphenyldiamine and detergents were the main allergens. Mycotic infection was observed primarily among the workers using common bathrooms.

In patients with eczema nummulare patch tests with a panel of 18 allergens were done with positive result in 9 (18%) cases. In 6 cases multivalent allergy was found. Most frequently positive tests were obtained with potassium dichromate. The tests showed participation of contact allergy in the development of changes in a part of patients with eczema nummulare.

In the skin of healthy subjects linear deposits were found of fibronectin at the dermoepidermal junction and in the walls of blood vessels, and reticular deposits in the papillary and reticular layers of the skin. In the epidermis of 12 out of 51 patients with allergic contact dermatitis fibronectin deposits were found in relation to Langerhans cells and keratinocytes. This was not observed in the epidermis in healthy subjects. The authors suggest that fibronectin on the surface of Langerhans cells and keratinocytes may play a role in antigen presentation.

In a previous paper, we reported on nickel sensitivity in 2400 consecutive patients in 5 countries. 3 years later, we reassessed 104 of the 157 nickel-positive patients of this former study and found 13 now to be negative to nickel sulphate. Nearly all the others can no longer tolerate nickel contact. 68 patients were free from nickel dermatitis, 16 showed a very mild eczema or dyshidrosis, and 13 were suffering from chronic hand dermatitis. 42 of 104 patients had changed their occupation, 36 successfully, with clearance of skin lesions. Rehabilitation by avoidance of nickel-containing costume jewelry, wrist-watches and clothing buckles, and by change of occupation, is possible and necessary.

We report on investigations carried out on T. vaginalis and mixed infection (T. vaginalis and yeast-like fungi). Special attention was paid to metronidazol resistance on T. vaginalis strains isolated from patients who had been repeatedly treated with this medicament. Therefore we point to the necessity of defining the patients' susceptibility to this remedy.