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The aim of this study was to assess the effect of time and the ultrasonic activation of ethylenediaminetetraacetic acid (EDTA) in removing the smear layer of at root canal. A total of 60 bovine inferior incisors were transversely sectioned and instrumented; A smear layer was added in the root dentin surface. The specimen were then divided into six groups according to the following final irrigation protocols: Group (G) 1: conventional irrigation with sodium hypochlorite (NaOCl); G2: conventional irrigation with NaOCl + EDTA for 20 s; G3: conventional irrigation with NaOCl + EDTA for 60 s; G4: passive ultrasonic irrigation (PUI) with NaOCl; G5: PUI with NaOCl + PUI with EDTA for 20 s; G6: PUI + NaOCl and PUI with EDTA for 60 s. Samples were analyzed by scanning electron microscope (SEM) at ×500 increase. The images were measured by three blinded evaluators and classified in scores ranging from 1 to 5. The results were analyzed by the Pearson correlation test and the ANOVA nonparametric Kruskal-Wallis and Dunn's tests were used for the comparisons. Irrigated samples only with NaOCl (G1 and G4) had higher scores when compared with other groups. G5 and G6, irrigated with 17% EDTA and ultrasonic irrigation had lower scores. However, there was no statistically significant difference in G2 and G3, where there was no irrigation. It was concluded that irrigation with 17% EDTA for 20 s promoted the effective removal of smear layer, regardless of ultrasonic irrigation., (© 2016 Wiley Periodicals, Inc.)

The aim of this study was to evaluate the influence of different passive ultrasonic irrigation protocols on the removal of debris in artificially created grooves in the cervical, middle and apical root thirds. Forty extracted bovine incisor roots were instrumented to 1 mm of the root apex with a R50 Reciproc instrument and irrigated with 2.5% sodium hypochlorite. The roots were then inserted in a muffle and cleaved into two hemisections. Grooves (3-mm long) were done at 2, 7 and 12 mm from the root apex in one hemisection and filled with dentinal debris. The hemisections were regrouped into the muffle and divided into 4 groups (n=10) according to the final irrigation protocol: Control group: 3x20 s using a #30 gauge needle without agitation of the irrigating solution; Group PUI-s (static passive ultrasonic irrigation): 3x20 s of passive ultrasonic irrigation with the tip of the insert maintained static on the apical third; Group PUI-t (passive ultrasonic irrigation per third): 20 s of PUI in each third; Group PUI-d (passive dynamic ultrasonic irrigation): 3x20 s of PUI dynamically moving the insert in the whole extent of the root canal. In all groups, was used a total of 6 mL of 2.5% sodium hypochlorite as irrigant. After these procedures, the grooves were analyzed with a stereomicroscope and assigned scores as regards removal of the debris. The data were analyzed statistically (a=0.05). The results showed a better cleaning in all the groups where the irrigating solution was agitated with ultrasonic device than in the control group (p<0.05). In the apical third, the PUI-d and PUI-s showed similar performance (p>0.05) and a better cleanness than PUI-t (p<0.05). The dynamic and static methods of agitation of the irrigating solution provided more effective cleaning. PUI-d provided the most completely clean grooves suggesting that its use is the most adequate in cases of teeth with complex canal anatomy.

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The cities of today present requirements that are dissimilar to those of the past. There are cities where the industrial and service sectors are in decline, and there are other cities that are just beginning their journey into the technological and industrial sectors. In general, the political and social realms have been restructured in terms of economics, which has resulted in an entirely different shape to the primitive structures of civilization. As people begin to understand the dynamic nature of landscapes, they stop seeing landscapes as a static scene. Sustainable cities must be simultaneously economically viable, socially just, politically well managed and ecologically sustainable to maximize human comfort. The present research suggests a multi-disciplinary approach for attaining a holistic understanding of urban environmental quality and human well-being in relation to sustainable urban development., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The extrusion of sodium hypochlorite through the apical foramen is an accident that can occur during the flushing procedure in endodontic treatment. The symptomatology is immediate and intense, and there is a long period before the tissues return to normal. Low-level laser therapy might be useful as an adjunctive treatment for damaged soft tissues because of its anti-inflammatory and analgesic effects, which may reduce edema and prevent infection. In this clinical case, the accidental leakage of 1% sodium hypochlorite during the preparation of the root canal of a maxillary right central incisor is reported. This leakage caused immediate and intense pain and edema formation and resulted in an extensive necrotic area in the alveolar mucosa adjacent to the root of the treated tooth. The conventional treatment protocol was combined with low-level laser therapy. Clinical and radiographic examinations after 7 months revealed complete repair of the necrotic area with no paresthesia and further indicated the integrity of the apical region of the tooth where the extrusion of sodium hypochlorite occurred. The combination of low-level laser therapy with a conventional treatment protocol in this case of the extrusion of 1% sodium hypochlorite resulted in the healing of the wounds., (Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Purpose: To describe the prevalence of malformations found in fetuses with trisomy of chromosomes 13, 18 and 21 by identifying the most frequent within each condition., Methods: A retrospective cross-sectional study with the analysis of trisomy cases of chromosomes 13, 18 and 21 diagnosed through fetal karyotype obtained by amniocentesis/cordocentesis, between October 1994 and May 2014, at a Teaching Hospital in Brazil Southern Region. Malformations identified through morphological ultrasonography were described and, subsequently, confirmed in newborn examinations and/or fetal autopsy. The results were analyzed using Fisher's test and analysis of variance (ANOVA), with a 5% level of significance (p=0.05)., Results: Sixty-nine cases of trisomy were diagnosed among 840 exams; nine were excluded due to outcome outside Hospital de Clínicas de Porto Alegre or incomplete records, remaining 60 cases (nine cases of chromosome 13 trisomy, 26 of chromosome 18, and 25 of chromosome 21). In all three groups, heart disease occurred in most cases; the ventricular septal defect was more prevalent and occurred in 66.7% of the trisomy 13 group. Gastrointestinal abnormalities were more prevalent in the trisomy 18 group, especially omphalocele (38.5%; p<0.01). Genitourinary anomalies were more significantly frequent in the trisomy 13 group (pyelectasis, 55.6% - p<0.01; ambiguous genitalia, 33.3% - p=0.01). Central nervous system defects were identified in all cases of trisomy 13. Facial cracks were significantly more prevalent among fetuses with trisomy 13 (66.7%; p<0.01). Hand and feet malformations significantly differed among the trisomy groups. Hand defects occurred in 50% of trisomy 18 cases, and in 44.4% of all trisomy 13 cases (p<0.01); congenital clubfoot was more common in the trisomy 18 group, being detected in 46.2% of fetuses (p<0.01). The abnormalities were found in 50.9, 27.3 and 21.7% of trisomy 18, 13 and 21 cases respectively., Conclusion: Many fetal malformations identified at ultrasound are suggestive of trisomy and represent an important tool for etiologic diagnosis and prenatal and pre-conception genetic counseling.

Calcifying cyst odontogenic tumor (CCOT) is a rare benign cystic neoplasm of odontogenic origin whose treatment depends on the lesion's localization and histological type. The purpose of this report was to describe a case of extensive calcifying cyst odontogenic tumor involving the maxilla of a 12-year old female patient and the treatment option adopted. The lesion was associated with an impacted first premolar, and the roots of the canine and second premolar were divergently displaced. An incisional biopsy revealed the presence of a highly cellular, densely fibrous connective tissue, with diffuse infiltration of mononuclear inflammatory cells. Cystic marsupialization and extraction of the impacted premolar were performed. No signs of lesion recurrence were noted after 28 months. Therefore, marsupialization should be considered when planning CCOT treatment, primarily in young patients with large lesions, to avoid mutilations and tooth loss.

Objective: To describe a case of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome associated with bilateral myomas in uterine remnants., Design: Case report., Setting: University hospital., Patient(s): A 35-year-old woman with MRKH syndrome and pelvic pain, in whom leiomyomas were diagnosed by imaging techniques., Intervention(s): Diagnostic laparoscopy followed by excision of leiomyomas and uterine remnants by laparotomy., Main Outcome Measure(s): Resolution of symptoms and histologic confirmation of the clinic diagnosis., Result(s): After a 6-month follow-up period, the patient was asymptomatic. The histologic examination confirmed MRKH syndrome associated with multiple myomas in both rudimentary uteri., Conclusion(s): This is an unusual case of MRKH syndrome associated with bilateral leiomyomas. The excision of the tumors with the adjacent uterine remnants is indicated when they are symptomatic.

The human lysozyme (LZM) gene is highly methylated in LZM-nonexpressor immature myeloid and in nonmyeloid cells and unmethylated only in LZM-expressing cells. Extended methylation analyses of the CpG-poor 5' flanking region and of the exon 4 CpG island (both containing Alu elements) of the LZM gene were now performed. Marked demethylation was noted after treatment of AML1/ETO-positive Kasumi-1 cells with the DNA methyltransferase (DNMT) inhibitor 5-aza-2'-deoxycytidine (5-azaCdR), not associated with cellular differentiation. LZM mRNA in Kasumi-1, but not in several AML1/ETO-negative myeloid cell lines, was specifically and independently up-regulated upon treatment with 5-azaCdR and, to a lesser extent, with the histone deacetylase (HDAC) inhibitor trichostatin A (TSA). Increased chromatin accessibility within the 5' LZM gene was observed concomitantly with 5-azaCdR-induced demethylation. In contrast, TSA treatment had no effect on chromatin accessibility, but, as shown by chromatin immunoprecipitation, resulted in increased acetylation of histones H3 and H4. Repression of LZM transcription is mediated by conditional AML1/ETO expression in an inducible cell line model (U-937), and is reversed by siRNA "knock-down" of AML1/ETO in Kasumi-1 cells (Dunne et al., Oncogene 25: 2006). Antagonization of LZM repression following conditional expression of AML1/ETO was achieved by TSA. In conclusion, we demonstrate complex interactions between DNA methylation and histone modifications in mediating LZM repression, which implicate AML1/ETO as one component involved in local chromatin remodeling. Interestingly, inhibitors of DNMTs and HDACs independently relieve repression of this CpG-poor gene in AML1/ETO-positive cells.

Purpose: Our goal was to investigate the safety, effectiveness, and feasibility for the practicing physician of stepwise and low-dose administration of FSH in WHO group II anovulatory infertile women., Methods: Infertile female patients (n = 234) suffering from WHO group II anovulation, and who failed to became pregnant with clomiphene citrate, were included in a multicenter, prospective, clinical study of treatment with a protocol of chronic low-dose and small incremental rises with urinary purified or highly purified FSH. Follicular development was monitored with ultrasonographic scans., Results: The 234 patients received a total of 534 cycles of treatment, for a mean number of 2.3 treated cycles per patient. hCG was withheld in 65 (12.2%) cyles because of no response and in 28 (5.2%) cycles because of hyperresponse. Of the remaining 441 cycles, 419 (95%) were ovulatory, and in 198 (47.3%) of these cycles a single dominant follicle developed. There were 93 pregnancies (39.7% per patient), for a cycle fecundity rate of 17.4%. Cumulative conception rate after two treated cycles was 33.5%. There were 14 (15%) pairs of twins and 10 (10.8%) spontaneous miscarriages. The prevalence of complications was low with no cases of severe OHSS. Basal LH/FSH ratio was significantly higher in the pregnant group of patients than in nonpregnant women., Conclusions: Stepwise and chronic low-dose administration of FSH is a safe and effective method for treatment of WHO group II anovulatory infertility, mainly in those patients having high LH/FSH ratios.

A ouabain-insensitive, K+-independent, sodium pump, has been demonstrated in guinea-pig and rat kidney proximal tubular cells. This pump is thought to be distinct from the ouabain-sensitive Na+/K+ pump. We present evidence here indicating the modulation of the biochemical expression of the Na+ pump, i.e. the ouabain-insensitive Na+-ATPase, by the cell volume in rat kidney proximal tubular cells. Thus, basolateral plasma membranes from swollen cells show a ouabain-insensitive Na+-ATPase activity 10-times higher than that in membranes from control cells. If the swollen cells recover their volume, the activity decreases ten times to control values. The ouabain-sensitive Na+/K+-ATPase is not affected by changes in the cell volume.