Lamotrigine hypersensitivity in childhood epilepsy

PURPOSE: To evaluate the effect of lamotrigine (LTG) on several humoral and cellular immune functions in children with epilepsy and the change in immunological status in patients with LTG-induced rash. METHODS: Sixteen children with epilepsy of unknown origin or secondary to various etiologies undergoing treatment with LTG participated in the humoral and cellular immunological study. Of these, 2 patients developed a rash during LTG treatment and are described in detail. RESULTS: No modifications of humoral or cellular immunity (measured at 1 and 3 months) were noted in 14 of the 16 patients during this treatment. In the 2 children who manifested rash, basal immune function was normal. In both, immediately after the skin rash appeared, there was a high increase in the percentage of activated T-helper lymphocytes (CD4-DR) and activated T-suppressor lymphocytes (CD8-DR), a slight increase in percentage of B lymphocytes (CD19), and a greater increase in serum concentration of IgE. In 1 of the 2 patients, reevaluation of immunity 20 days after the rash appeared and after LTG suspension showed normal percentages of CD4-DR, CD8-DR, and CD19, whereas the serum concentration of IgE had decreased. CONCLUSIONS: The observed immunological results indicate that LTG-induced rash may be considered an immune-mediated hypersensitivity reaction.     

Anti-fingerprints fluorinated coating for anodized titanium avoiding color alteration

In this study amorphous fluorinated coatings applied to anodized titanium surface have been investigated. A copolymer between tetrafluoroethylene and perfluoro-4-trifluoromethoxy-1,3-dioxole (AD60) and two perfluoropolyether containing ammonium phosphate (F10) or triethoxysilane (S10) functionalities have been tested. To estimate the color alteration of the anodized titanium surfaces due to the application of the coatings, spectrophotometric analyses have been made. Water and n-dodecane contact angles as well as apparent surface energy have been evaluated. Ellipsometry and atomic force microscopy data have been used to measure the thickness of the fluorinated coatings. A tailored mechanical preliminary test has also been explored to evaluate the adhesion of the coatings on the anodized titanium surface. The resistance to surface soiling with castor oil was also preliminarily investigated. The fluorinated coating tested on anodized titanium showed a low apparent surface energy and high chromatic aspect conservation, this is particularly evident for the titanium anodized coated with triethoxysilane functionalities fluoropolymers S10.     

Study and planning of the surgical procedure for the orbital district in patients affected by craniofacial malformations

Orbital surgery is of critical importance within the framework of craniofacial surgery. The conical conformation of orbits requires analysis and surgical procedure planning methods involving all three dimensions. We present our protocol for the analysis and our three-dimensional surgical procedure plan to treat orbital malformations using teleradiography and two- and three-dimensional computed tomographic imaging. A number of clinical cases treated according to this approach are also presented.     

Catecholaminergic innervation of the human dura mater involved in headache

The effects of pulsed Nd:YAG laser irradiation with different laser initiators on the permeability and ultrastructure of the root canal wall dentin were investigated in vitro. Forty extracted human single-rooted teeth were randomly assigned to four groups. Group 1 teeth were not lased as a control. Group 2 specimens received four 10-s duration laser exposures for a total exposure of 40 s/canal. In group 3 specimens, the root canals were painted with black ink and then lased by the same method as group 2 teeth. In group 4 specimens, root canals were treated with 38% Ag(NH3)2F and then lased by the same method as group 2 teeth. Laser parameters were set at 2 W, 20 pps. After being placed in 0.6% rhodamine B solution for 48 h, the teeth were sectioned for study by stereoscope and scanning electron microscopy. Statistical analysis showed there were significant differences (p < 0.05) in dentin permeability in the apical areas between groups 3 and 1, 4 and 1, and 4 and 2. Scanning electron microscopic examination showed that laser treatment alone had no obvious effects on the root canal wall. The root canal surfaces prepared for by laser irradiation with black ink or 38% Ag(NH3)2F revealed melting, smear layer evaporation, and open dentinal tubules. Black ink was more effective than 38% Ag(NH3)2F as a Nd:YAG laser initiator.     

Deviated nose: technical proposition for prevention of recurrences

Ultrasonography of the gallbladder was performed in 3 groups of dogs: 30 clinically healthy dogs, 50 dogs with hepatobiliary disease, and 50 dogs with diseases other than hepatobiliary disease. The gallbladder was evaluated for the presence of sludge (echogenic material without acoustic shadowing). Maximal gallbladder length, width, height, and area were measured as well as the gallbladder wall thickness. The relative sludge area was calculated as the ratio of sludge area over gallbladder area on longitudinal images. No significant difference was found in the prevalence of gallbladder sludge among healthy dogs (53%), dogs with hepatobiliary diseases (62%), and dogs with other diseases (48%). The mean age of dogs with sludge was higher than the mean age of dogs without sludge in dogs with hepatobiliary disease and dogs with other diseases (p < 0.05). The mean relative sludge area did not differ significantly among the 3 groups. A trend to larger gallbladder dimensions in dogs with sludge compared to dogs without sludge was detected within the 3 groups. The gallbladder wall thickness was not different between dogs with and without sludge within the 3 groups. However, the gallbladder wall was more frequently isoechoic than hyperechoic to the liver in dogs with sludge than in dogs without sludge. The results of this study indicate that gallbladder sludge, in dogs, is not particularly associated with hepatobiliary disease and should be considered an incidental finding.     

Influence of repeated extrusions on some properties of non-conventional spaghetti

The influence of the re-extrusion (repeated extrusion) number on the rheological properties of non-conventional doughs, mechanical and sensorial characteristics of dry spaghetti was investigated. Moreover, the dough gelatinization degree was also evaluated. Amaranth, oat and quinoa flours were used to produce the spaghetti samples. Twelve non-conventional spaghetti samples were manufactured varying the re-extrusion number. The rheological properties of doughs were determined using a capillary rheometer, the mechanical characteristics of dry spaghetti by a dynamic mechanical analyzer and the sensorial parameters by a trained panel. The re-extrusion number affected the extensional and shears viscosity of amaranth, oat and quinoa dough samples. The breaking strength of dry non-conventional spaghetti increased with the increase of the re-extrusion number for amaranth and oat. The dough gelatinization degree of the quinoa and oat significantly increased with the re-extrusion, whereas no influence of re-extrusion was found for the amaranth dough. Moreover, the re-extrusion number improved sensorial color and homogeneity for oat and quinoa dry spaghetti and had no effects on the sensorial characteristics of all cooked spaghetti.     

Use of rigid external fixation in fractures of the mandibular condyle

In this article the use of a rigid external fixation system is proposed for the early treatment of condylar fractures. This method offers the advantage of not damaging the articular structures during reduction and allows early mobilization for a rapid recovery. In our Centre 28 patients have been treated with the rigid external fixation system, with good functional results. Of these 15 men and 13 women, 22 had a monocondylar fracture and 6 had a bicondylar fracture. In all the cases there was complete recovery of the occlusal stituation and of the mouth opening; no patient surgically treated with this method has ever presented problems of a local or general nature. The purpose of this report was to evaluate the use of external fixation for the treatment of extracapsular condylar fractures with luxation of the fragment out of the glenoid cavity.     

New approach to the surgical treatment of severe exophthalmos in Graves disease

In the last few years, various surgical techniques to correct orbital decompression in patients with Graves ophthalmopathy have been proposed. In those patients in whom a high degree of exophthalmos is mainly the result of the hypertrophied endorbital muscles with respect to endorbital fat hypertrophy, lipectomy is insufficient to obtain an acceptable increase of endorbital volume. The authors propose a method that provides for the monobloc bilateral quadrantotomy by extracranial access. Despite traditional methods of decompression, the advantage of this technique is better advancement of the orbital margins. The bicoronal and endoral incisions guarantee no facial scars. Compared with the craniotomy, the extracranial access is also less stressful for the patient.     

MCD Diet Rat Model Induces Alterations in Zinc and Iron during NAFLD Progression from Steatosis to Steatohepatitis

We evaluate the effects of the methionine-choline-deficient (MCD) diet on serum and hepatic zinc (Zn) and iron (Fe) and their relationships with matrix metalloproteinases (MMPs) and their modulators (TIMPs and RECK) as well as hepatic fatty acids using male Wistar rats fed 2-, 4- and 8-week MCD diets. Serum and hepatic Zn decrease after an 8-week MCD diet. Serum Fe increases after an 8-week MCD diet and the same occurs for hepatic Fe. An increase in hepatic MMP activity, associated with a decrease in RECK and TIMPs, is found in the MCD 8-week group. Liver Fe shows a positive correlation versus MMPs and RECK, and an inverse correlation versus TIMPs. A positive correlation is found comparing liver Zn with stearic, vaccenic and arachidonic acids, and an inverse correlation is found with linolenic and docosatetraenoic acids. An opposite trend is found between liver Fe versus these fatty acids. During NAFLD progression from steatosis to steatohepatitis, MCD rats exhibit an increase in Zn and a decrease in Fe levels both in serum and tissue associated with alterations in hepatic MMPs and their inhibitors, and fatty acids. The correlations detected between Zn and Fe versus extracellular matrix modulators and fatty acids support their potential role as therapeutic targets.