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Biomedical subjects

A Modesto

Publications and source records attributed to A Modesto.

At least 19 recordsLinked to original sources
PubMed2006

Gastrointestinal stromal tumour: spiral computed tomography features and pathologic correlation.

PURPOSE: Our purpose was to define the diagnostic accuracy of helical computed tomography (CT) in the identification, characterisation and evaluation of extension of gastrointestinal stromal tumours (GIST) through correlation with some pathological findings. MATERIALS AND METHODS: Between August 2000 and September 2004, we conducted a retrospective study of the abdominal CT of 15 patients with histological diagnosis of GIST - that is, the immunopositivity for c-kit (CD117) - on a surgical specimen of the primary disease. We used a helical CT single-slice (Toshiba, Asteion; rotation time 0.75 s) in ten cases and helical CT multislice (Toshiba, Aquilion; 4 slices/rotation; rotation time 0.5 s) in five cases. In all cases, we used an organ-iodate nonionic contrast agent intravenously at a concentration of 350-400 mgI/ml. All cases studied the entire abdomen. Site, morphology and tumour size (smaller than 5 cm, 5-10 cm and larger than 10 cm) were considered parameters for tumour identification. Size, partial or total extraluminal tumour growth, homogeneous or inhomogeneous lesion enhancement and the eventual presence of calcifications were assumed to be criteria for characterisation of a GIST. Hepatic, peritoneal and/or lymph node metastases were considered parameters of intermediate or high malignancy. We correlated the results with some pathological features derived from the analysis of surgical tissue: site, morphology and tumour size, tissue components and risk of malignancy of GIST (on the basis of the 2002 Fletcher classification). RESULTS: We demonstrated one substantial concordance between radiological and pathological valuation of site, morphology, tumour size and absence of intralesional calcifications of GIST. Nine of ten GIST smaller than 5 cm, the two 5-10 cm and the three larger than 10 cm presented extraluminal growth. Enhancement was inhomogeneous in five of ten lesions smaller than 5 cm and in all cases larger than 5 cm. At pathological analysis, in all cases of inhomogeneous enhancement, solid, hemorrhagic, necrotic and cystic areas were found. Of seven tumours of intermediate malignancy, six were smaller than 5 cm and only one larger than 10 cm; the two 5-10 cm were of high malignancy and all tumours superior of 10 cm were at intermediate or high malignancy. Of the two cases with metastases, one was of intermediate and one of high malignancy. In the other cases of intermediate or high malignancy, metastases were absent. CONCLUSIONS: The immunopositivity for c-kit is requisite for definitive diagnosis of GIST, but imaging, and particularly helical CT, has a primary role. In this study, CT is was reliable for tumour identification. All tumours larger than 5 cm presented extraluminal growth, inhomogeneous enhancement, absence of calcifications and lymph node metastases. Furthermore, the tumour larger than 5 cm showed extraluminal growth and inhomogeneous enhancement. Tumour size established with CT was not sufficient to determine the degree of malignancy. Metastases at the time of diagnosis were indicative of intermediate or high malignancy, but the absence of metastases did not allow classification of GIST in the group of low and very low risk of malignancy.

Adult↗
PubMed2006

MSX1 and orofacial clefting with and without tooth agenesis.

MSX1 has been considered a strong candidate for orofacial clefting, based on mouse expression studies and knockout models, as well as association and linkage studies in humans. MSX1 mutations are also causal for hereditary tooth agenesis. We tested the hypothesis that individuals with orofacial clefting with or without tooth agenesis have MSX1 coding mutations by screening 33 individuals with cleft lip with or without cleft palate (CL/P) and 19 individuals with both orofacial clefting and tooth agenesis. Although no MSX1 coding mutations were identified, the known 101C > G variant occurred more often in subjects with both CL/P and tooth agenesis (p = 0.0008), while the *6C-T variant was found more often in CL/P subjects (p = 0.001). Coding mutations in MSX1 are not the cause of orofacial clefting with or without tooth agenesis in this study population. However, the significant association of MSX1 with both phenotypes implies that MSX1 regulatory elements may be mutated.

Adolescent↗
PubMed2004

MSX1, PAX9, and TGFA contribute to tooth agenesis in humans.

In this study, we sought to determine the association between tooth agenesis and DNA sequence variation in the genes MSX1 and PAX9 in an ethnically diverse human population. Since cleft lip/palate is also associated with both tooth agenesis and the gene TGFA, we included TGFA in the analysis as well. Cheek swab samples were obtained for DNA analysis from 116 case/parent trios. Probands had at least one developmentally missing tooth, excluding third molars. Genotyping was performed by single-strand conformational polymorphism or kinetic polymerase chain-reaction assays. Transmission distortion of the marker alleles and DNA sequence analysis was performed. Results showed that tooth agenesis is associated with markers of the genes MSX1 and TGFA. No mutations were found in MSX1 or PAX9 coding regions. There were statistically significant data suggesting that MSX1 interacts with PAX9. These findings suggest that MSX1, PAX9, and TGFA play a role in isolated dental agenesis.

Adolescent↗
PubMed2002

Multislice CT: technical principles and clinical applications.

The aim of this article is to describe the main technical differences between multi-slice Computed Tomography (CT) and spiral CT. We also briefly discuss the diagnostic benefits of this new technology which consolidates and expands on the results achieved with spiral CT in the 90s. More specifically, gantry speed and improved spatial resolution in the z axis considerably expand angiographic and cardiac applications, allow high-quality multiplanar and 3D reconstructions, and introduce CT in organ perfusion studies (particularly those of heart and brain).

Algorithms↗
PubMed2000

Formation of alkali-soluble fluoride on the surface of human dental enamel after treatment with fluoridated gels: influence of the pH variation and of the treatment time.

The aim of this study was to quantify, in vitro, the formation of CaF2 after the application of three fluoridated gels: one neutral, one acidulated and another highly acidulated, on a bovine enamel dental surface treated with a Dijkman's demineralizing solution (1990). 145 sections were utilized, obtained from 145 sound teeth and divided into seven groups: C (enamel without treatment); FN1 (enamel demineralized and treated with neutral gel for 1 minute); FN4 (enamel demineralized and treated with neutral gel for 4 minutes); FFA1 (enamel demineralized and treated with acidulated gel for 1 minute); FFA4 (enamel demineralized and treated with acidulated gel for 4 minutes); FAA1 (enamel demineralized and treated with highly acidulated gel for 1 minute) and FAA4 (enamel demineralized and treated with highly acidulated gel for 4 minutes). The formation of CaF2 was analyzed by SEM and chemically by Caslavska's method (1975). The average and standard deviations from the groups studied were respectively: C-0.63; 0.38; FN1-23.06; 16.52; FFA1-54.11; 49.00; FAA1-43.87; 32.66; FN4-34.92; 23.00; FFA4-67.91; 42.36; FAA4-56.03; 38.96. (Mann-Whitney non-parametric test). The time of application did not interfere in the CaF2 formation from the acidulated and highly-acidulated gels. A minor concentration of fluoride and amount of pH from highly-acidulated gel did not affect the higher formation from the CaF2 in relation to the acidulated gel in both cases when the application was evaluated.

Acidulated Phosphate Fluoride↗
PubMed2000

Craniometaphyseal dysplasia: case report.

Craniometaphyseal dysplasia is a rare genetic bone remodeling disorder characterized by undertubulation of the long bones, especially in the lower extremities, causing deformities of the metaphyses of the long bones, and sclerosis of the skull base or cranial bone hyperostosis. The authors report a case of craniometaphyseal dysplasia in an 8-year-old Brazilian child, emphasizing the importance of precocious diagnosis of this rare genetic disorder.

Bone Diseases, Developmental↗
PubMed2000

Pacifier-sucking associated with a bizarre habit: a case report.

A case of a child, who used the pacifier with an uncommon habit is presented. She pulled out the hair on the right side of her head after rolling it round the base of the pacifier. She then sucked it and swallowed it. Based on this report the authors are emphasizing the importance of accompanying the orofacial development of the child as from its first year of life.

Bezoars↗
PubMed2000

Effects of three different infant dentifrices on biofilms and oral microorganisms.

The purpose of this work was to evaluate the effects of infant dentifrices: A--with lactoperoxidase, glucose oxidase and lactoferrin; B--with 1100 ppm of NaF and sodium lauryl sulfate; C--with extract of calendula. The dentifrices were test on biofilms formed in vitro from saliva and dental plaque of infants, using reference strains A. viscosus (ATCC 43146); C. albicans (ATCC 51501); L. casei (ATCC 4646); S. mitis (ATCC 49456); S. mutans (ATCC 25175); S. oralis (ATCC 35037); S. sanguis (ATCC 10586); S. sobrinus (ATCC 27609) and isolated clinically microorganisms C. albicans, S. mitis, S. mutans, S. oralis, S. sanguis, S. sobrinus and Lactobacillus sp. Twenty infants were chosen, who were beginning treatment at the Infants Clinic of the Pediatric Dentistry Department, Federal University of Rio de Janeiro. A pool of unstimulated saliva and a pool of dental plaque were collected from which biofilms were produced. Supernatants from each dentifrice were prepared and concentrated and diluted solutions of the dentifrices and a control sterile diluent were tested against the biofilms produced, for 1 and 3 minutes, and against the microorganisms. The results were statistically analyzed by the ANOVA and Tukey Test. After the exposure of the biofilms produced both from saliva and from dental plaque, to the dentifrice B concentrated and 1/2, for 1 and 3 minutes, the viable microorganisms count (CFU/ml), compared to the controls, was significantly reduced (p < 0.05). However, exposure to the dentifrices A and C concentrated and dentifrice B 1/4 and 1/8, for 1 and 3 minutes, was not significantly lethal to the biofilms. The dentifrices A and C, either concentrated or diluted (1/2 to 1/128) and the dentifrice B in the dilutions 1/16 to 1/128 did not have an antimicrobial effect on any microorganism evaluated. For all the microorganisms evaluated, the dentifrice B concentrated and in the 1/2 dilution showed a significant antimicrobial effect, when compared with the control (p < 0.05).

Actinomyces viscosus↗
PubMed1999

Predicting factors of long-term results of OKT3 therapy for steroid resistant acute rejection following cadaveric renal transplantation.

In this retrospective study, we evaluated the histological and biological predictors of long-term response of renal transplant (RT) patients treated with orthoclone OKT3 for steroid resistant acute rejection (AR). Seventy-three patients, aged 37 +/- 12 years, were included in this study between March 1987 and December 1996. All the patients but one had received sequential quadruple immunosuppression (polyclonal antilymphocyte globulins; steroids; azathioprine, and cyclosporin A). OKT3 (5 mg/day for 10 days) was administered for biopsy-proven steroid resistant AR i.e., after 3 consecutive pulses of methylprednisolone (10 mg/kg each). This was the first AR in 46 cases, the second AR in 22 cases and the third AR in 4 cases. Renal histology (Banff) showed borderline (BL) changes in 18 patients, grade I AR in 28 patients; grade II AR in 22 patients, and grade III AR in 5 patients. When treatment with OKT3 commenced (107 +/- 18 days post-transplantation) the mean serum creatinine (SCr) level was 325 +/- 195 micromol/l; this had decreased to 191 +/- 106 micromol/l by the end of OKT3 therapy. The immediate response to OKT3 therapy i. e., within the first month, was not dependent on the histological score. Twenty-six patients (35%) subsequently experienced at least one more AR episode of whom 4 were retreated with OKT3. The overall patient's survival was 94.5% at last follow-up. The overall cumulative graft survival was 64.5% at 2 years, 52.5% at 5 years, and 40.5% at 8 years. The graft survival (5 years) tended to depend on the initial histological score, i.e. BL 30%; grade I 66%; grades II and III 55.5% (p = 0.08). In a multiple logistic regression analysis we tried to identify independent factors that would predict that a graft would still be functioning at least 2 years after OKT3 therapy. We therefore analyzed the following parameters: donor and recipient's age; gender; cold ischemia time; HLA matching; panel reactive antibodies (PRA) prior to grafting; previous transplantation(s); total number of AR episodes; the time of onset of the AR treated by OKT3 compared to the other AR; the time of onset of the AR treated by OKT3; SCr levels at days 0, 10 and 30 after OKT3 therapy; histological score (Banff) i.e., the magnitude of AR and the presence or absence of chronic lesions. The only independent factors which would predict that a graft was still functioning 2 years after OKT3 therapy were: PRA <25% (Odds ratio (OR) 7.68 (1.15-51.3); p = 0.035); a grade I AR (OR 10.52 (1.18-93. 5); p = 0.035); SCr level 1 month after OKT3 therapy (OR 0.935 (0. 87-1.002); p = 0.05). HLA matching and the presence of histological chronic lesions were nearly significant (p = 0.06 and 0.09 respectively). In conclusion, this retrospective study shows that independent predictors of the long-term response to OKT3 therapy for AR in RT patients are the magnitude of pre-transplant PRA, the histological score, and the SCr level one month after OKT3 therapy.

Acute Disease↗
PubMed1999

Fluoride uptake and release by composites and glass ionomers in a high caries challenge situation.

PURPOSE: To evaluate the behavior of composite resins and glass ionomer cements with regard to the uptake and release of fluoride, in a high caries challenge situation. MATERIALS AND METHODS: Standard test specimens of glass ionomer cement (Chelon Fil), a resin-modified glass ionomer (Vitremer), two polyacid-modified composite resins (VariGlass and Dyract) and a composite resin (Heliomolar), were submitted for 14 days to demineralization and remineralization cycles in order to simulate a high caries challenge, while from the eighth day onward, a fluoridated dentifrice solution was applied for 5 minutes twice a day and the daily fluoride release of those materials to the mediums was quantified and compared. Fifteen test specimens were prepared for each material, making up a total of 75. RESULTS: All materials studied, except for Heliomolar from day 4 to day 7 in the demineralizing solution, were capable of releasing fluoride in measurable quantities during the whole experiment. The fluoride amounts released by Chelon Fil, Vitremer, VariGlass and Dyract were significantly higher in the demineralizing solution (ANOVA, P < 0.05) than in the remineralizing solution, during almost the entire experiment. The fluoride amounts released by Heliomolar were significantly higher in the remineralizing solution (ANOVA, P < 0.05) than in the demineralizing solution, during almost the entire experiment. All materials studied were capable of uptaking fluoride from the dentifrice solution and of later releasing it to the solution, maintaining the release relatively constant and at a higher level than that seen between days 5 and 7.

Acrylic Resins↗
PubMed1998

Serological markers of autoimmunity in renal transplant patients with chronic hepatitis C.

The aims of this prospective study were to assess the frequency of serological markers of autoimmunity and cryoglobulins in renal transplant (RT) patients presenting with chronic hepatitis C, and to correlate them with serum alanine aminotransferase (ALT) levels, hepatitis C virus (HCV) genotypes and viremia, and HLA-DR phenotypes. Three groups of patients were studied: group I comprised 74 HCV + ve RT patients; group II, 33 HCV-ve RT patients, and group III, 13 HCV-ve/hepatitis B virus (HBV)-positive RT patients. The three groups did not differ significantly according to their mean age, sex ratio and baseline immunosuppression. Serum specimens of these patients were tested for complement (hemolytic activity (CH50), C3, C4 and properdin factor B (PFB) components, rheumatoid factor (RF), immunoglobulin patterns, circulating immune complexes, and autoantibodies including antinuclear (ANA), anti-smooth muscle (ASMA), antimitochondrial, antithyroid microsomal (ATM), antithyroglobulin (ATG) and anti-LKM1 autoantibodies. We also looked for the presence of cryoglobulins in groups I and III. Cryoglobulinemia of type II was present in 2 patients of group I (2.7%) which was associated in 1 case with de novo membranoproliferative glomerulonephritis but was not found in any of the patients of group III. RF (> 40U/ml) were more frequently observed in groups I (55.4%) and III (46%) than in group II (20.6%), although the difference was not statistically significant (p = 0.06). Oligoclonal or monoclonal serum immunoglobulin patterns were present in 16.2% of the patients in group I, 15.4% in group III and only 3.3% in group II (p = 0.07). There was no significant difference between the prevalence of at least one autoantibody in the three groups (ranging from 38.5 to 50%), and neither was the frequency of ANA (23-36.6%), even at a high titer i.e. above 1:320, or ASMA (13.5-23%) significantly different. Conversely, tissue-specific autoantibodies, i.e. ATM, ATG and anti-LKM1, were only observed in HCV+ve patients. CH50, C3, C4 and PFB levels were significantly lower in group I than in group II, although values below the normal ranges were observed only for CH50 and C3 and were mostly found in the HCV+ve RT patients. Circulating immune complexes detected by nephelometry were at similar levels in the three groups, within the normal ranges. The occurrence of at least one autoantibody and/or the presence of RF > 40 U/ml did not correlate with either serum ALT levels or a given HLA-DR phenotype in any of the three groups, nor did they correlate with HCV genotype or HCV viremia in group I. In conclusion, this study shows that contrary to HCV+ve immunocompetent patients, HCV+ve RT patients rarely present with cryoglobulinemia and have the same frequency of non-organ-specific autoantibodies as HCV-ve RT patients. Conversely, antithyroid autoantibodies are only observed in the former group. Finally, serological markers of autoimmunity are not related to serum ALT levels, HLA-DR phenotype, HCV viremia or HCV genotype in HCV+ve RT patients.

Adult↗
PubMed1998

IgA nephropathy complicating diabetic glomerulosclerosis.

A retrospective study was done on 66 diabetic patients who had renal biopsies performed during 1979-1994. This review shows 10 patients who presented IgA nephropathy associated with diabetic nephropathy. Six patients had insulin-dependent diabetes mellitus and 4 patients non-insulin-dependent diabetes mellitus. All patients presented with proteinuria and 7 had hematuria. Four patients presented with renal impairment. Histologic evaluation disclosed the presence of thickened glomerular basement membranes and increased mesangial matrix in all cases, associated with nodular sclerosis in 8 cases. By immunofluorescence, diffuse mesangial IgA deposits were observed in all cases. The high incidence of the coexistence of IgA nephropathy and diabetes seems not merely coincidental. Structural and/or functional abnormalities of the glomerular basement membranes might facilitate the development of immune complex glomerular diseases. In patients with diabetes, the appearance of urinary abnormalities and/or deterioration in renal function altered the clinical history of diabetic nephropathy. The disorders are clinically suggestive of the presence of nondiabetic renal disease and raised the possibility of another pathogenetic mechanism.

Adult↗
PubMed1997

Outcome of patients with antineutrophil cytoplasmic autoantibody-associated vasculitis following cadaveric kidney transplantation.

In this retrospective study, we report on the progress of eight patients with biopsy-proven systemic vasculitis following cadaveric renal transplantation. Extrarenal manifestations associated with antineutrophil cytoplasmic autoantibodies (ANCAs) were present in all but one case. All the patients were on cyclosporine A-based immunosuppression, and none of them had active disease at transplantation. The mean time from the last episode of vasculitis to transplantation was 46 months (range, 10 to 132 months). On the day of transplantation, all but one patient had detectable ANCAs, which ranged from 1:100 to 1:2,000 (perinuclear ANCAs [P-ANCAs], four patients; cytoplasmic ANCAs [C-ANCAs], three patients). There were three patients with Wegener's granulomatosis, none of whom relapsed. Of those patients with microscopic polyangiitis (P-ANCAs, three patients; C-ANCAs, two patients), only one presented with relapse episodes after transplantation; the episodes involved the lungs and the kidney graft, and were successfully treated by methylprednisolone pulses. This patient had the highest ANCA titer before (1:2,000) and after (up to 1:10,000) grafting, and received no immunosuppression prior to transplantation since vasculitis was diagnosed after she had developed end-stage renal failure. This study shows that a relapse of ANCA-associated vasculitis following successful cadaveric renal transplantation occurs infrequently in the cyclosporine A era (ie, 12%), despite the persistence of circulating ANCAs in these patients at the time of transplantation, and even afterward in some cases.

Adult↗
PubMed1997

Fluoride uptake in situ after the use of dental floss with fluoride.

The possibility of having a commercial product such as waxed floss with an additional agent for controlling and preventing caries is promising. The aim of this research was to determine the uptake of fluoride on tooth enamel in situ after the utilization of a dental floss with fluoride incorporated into the wax. One hundred blocks of bovine enamel were artificially demineralized and randomly separated into a Control Group (C) and a Test Group (T). The dental blocks in group T were mounted two-by-two simulating proximal contacts and were fixed into intra-oral lower arch devices. Eight volunteers with a similar salivary flow and buffer capacity wore devices with the enamel blocks for eight days. During this period of time the subjects applied a 25 cm long portion of a mint waxed floss with fluoride (0.15 mgF/m, Oral-B) between the blocks, 3 times a day for 2 minutes after each meal. At the same time, brushing was carried out with a fluoride-free toothpaste. The alkali-soluble fluoride (CaF2) formed on the enamel was extracted using the Caslavska et al. method and measured with the Orion 96-09 electrode-specific and the EA 720 ion analyzer. The results showed that the group that had the most CaF2 on the enamel (median, minimum and maximum in microF/cm2) was Group T (3.00, 2.11 and 4.00), which differed significantly (p < 0.01) from group C (0.26, 0.10 and 0.69). It was concluded that fluoride uptake on enamel was 11.54 times higher after use of dental floss with fluoride in this study.

Adult↗