Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review

Odontogenic cysts are considered as nonneoplasic benign lesions. Among the cysts, keratocyst odontogenic tumor (KCOT) is an intra‑osseous tumor characterized by parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior, and for the possibility to develop carcinomas in the lesion wall. Thus, the aim of this study was to describe a clinical case of KCOT in a young patient and discuss the treatment alternatives to solve this case. A 15‑year‑old male was referred for treatment of a giant lesion in his left side of the mandible. After the biopsy, a diagnostic of KCOT was made, and the following procedures were planned for KCOT treatment. Marsupialization was performed for lesion decompression and consequent lesion size reduction. Afterward, enucleation for complete KCOT removal was performed followed by third mandibular molar extraction. After 5 years, no signs of recurrence were observed. The treatment proposed was efficient in removing the KCOT with minimal surgical morbidity and optimal healing process, and the first and second mandibular molars were preserved with pulp vitality. In conclusion, this treatment protocol was an effective and conservative approach for the management of the KCOT, enabling the reduction of the initial lesion, the preservation of anatomical structures and teeth, allowing quicker return to function. No signs of recurrence after 5 years were observed.

Influência da contaminação por Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) na espermatogênese de Triatomíneos (Hemiptera: Reduviidae)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo morfológico, morfométrico e molecular de espécies do complexo Triatoma brasiliensis (Hemiptera, Reduviidae, Triatominae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo genotípico de seis cepas de Trypanosoma cruzi (Kinetoplastida, Trypanosomatidae) isoladas de exemplares de Rhodnius Montenegrensis, Triatoma Rubrovaria e Triatoma Sordida (hemiptera, reduviidae)

A doença de Chagas, causada pelo protozoário flagelado Trypanosoma cruzi, foi descrita pelo pesquisador brasileiro Carlos Chagas em 1909. É transmitida ao homem por insetos hemípteros conhecidos como barbeiros dos quais os gêneros mais importantes são Panstrongylus, Rhodnius e Triatoma. Essa zoonose representa um risco para aproximadamente 20 milhões de pessoas em todo o mundo, principalmente na América Latina. Para tentar explicar as diferentes manifestações observadas na doença de Chagas, vários estudos foram realizados com intuito de averiguar as possíveis correlações entre as formas clínicas com a variabilidade genética do parasito. Algumas hipóteses estão relacionadas provavelmente ao fato de a doença ser um processo multifatorial, em que tanto aspectos do parasito como do hospedeiro estão inter-relacionados ou ainda a escolha inadequada de alvos como marcadores de patogenicidade na tentativa de estabelecer a correlação entre as formas clínicas e a variabilidade genética do parasito. Com o intuito de contribuir para ampliar o conhecimento sobre as populações de T. cruzi, foi realizada a cinética de crescimento em meio LIT e o estudo genotípico de seis cepas de T. cruzi isoladas de exemplares de R. montenegrensis, T. rubrovaria e T. sordida por meio de marcadores genotípicos utilizando as sequência dos genes 24Sα do DNA ribossomal, HSP60 e GPI.

Estudo biológico, morfológico e molecular de duas cepas de Trypanosoma Cruzi (Kinetoplastida, Trypanosomatidae) isoladas de exemplares de Triatoma Sordida e Triatoma Rubrovaria (Hemiptera, Reduviidae)

A doença de Chagas, conhecida também como tripanossomíase americana, foi descrita por Carlos Ribeiro Justiniano das Chagas em 1909 em Lassance, Minas Gerais. Ela é causada pelo protozoário Trypanosoma cruzi e transmitido ao homem por insetos hemípteros conhecidos como barbeiros dos quais os gêneros mais importantes são Panstrongylus, Rhodinus e Triatoma. Essa zoonose atinge aproximadamente 10 milhões de pessoas em todo o mundo, principalmente na América Latina. Sabe-se que esse parasito apresenta grande variabilidade intraespecífica evidenciada por diferenças na patologia, virulência, constituição antigênica e habilidade de evasão à resposta imunológica e essa diversidade pode estar associada à sua adaptação e sobrevivência em diferentes hospedeiros. A diversidade patogênica, imunológica e morfológica inerente a esse flagelado dependem de fatores ainda indeterminados, como variação regional e individual da doença humana em infecções naturais e experimentais. Com o intuito de contribuir para ampliar o conhecimento sobre as populações de T. cruzi, propõe-se o estudo biológico, morfológico e molecular de duas cepas isoladas dos exemplares, Triatoma sordida (SI7) e Triatoma rubrovaria (QMM12) por Rosa et al. 2004; 2008 coletados nos Estados da Bahia e Rio Grande do Sul, respectivamente.

Síntese e avaliação biológica de novos compostos das séries LAPDESF FUR-PQ E LAPDESF FUR-TS contra Trypanosoma cruzi

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo genotípico de seis cepas de Trypanosoma cruzi (Kinetoplastida, Trypanosomatidae) isoladas de exemplares de Rhodnius Montenegrensis, Triatoma Rubrovaria e Triatoma Sordida (hemiptera, reduviidae)

A doença de Chagas, causada pelo protozoário flagelado Trypanosoma cruzi, foi descrita pelo pesquisador brasileiro Carlos Chagas em 1909. É transmitida ao homem por insetos hemípteros conhecidos como barbeiros dos quais os gêneros mais importantes são Panstrongylus, Rhodnius e Triatoma. Essa zoonose representa um risco para aproximadamente 20 milhões de pessoas em todo o mundo, principalmente na América Latina. Para tentar explicar as diferentes manifestações observadas na doença de Chagas, vários estudos foram realizados com intuito de averiguar as possíveis correlações entre as formas clínicas com a variabilidade genética do parasito. Algumas hipóteses estão relacionadas provavelmente ao fato de a doença ser um processo multifatorial, em que tanto aspectos do parasito como do hospedeiro estão inter-relacionados ou ainda a escolha inadequada de alvos como marcadores de patogenicidade na tentativa de estabelecer a correlação entre as formas clínicas e a variabilidade genética do parasito. Com o intuito de contribuir para ampliar o conhecimento sobre as populações de T. cruzi, foi realizada a cinética de crescimento em meio LIT e o estudo genotípico de seis cepas de T. cruzi isoladas de exemplares de R. montenegrensis, T. rubrovaria e T. sordida por meio de marcadores genotípicos utilizando as sequência dos genes 24Sα do DNA ribossomal, HSP60 e GPI.

Estudo biológico, morfológico e molecular de duas cepas de Trypanosoma Cruzi (Kinetoplastida, Trypanosomatidae) isoladas de exemplares de Triatoma Sordida e Triatoma Rubrovaria (Hemiptera, Reduviidae)

A doença de Chagas, conhecida também como tripanossomíase americana, foi descrita por Carlos Ribeiro Justiniano das Chagas em 1909 em Lassance, Minas Gerais. Ela é causada pelo protozoário Trypanosoma cruzi e transmitido ao homem por insetos hemípteros conhecidos como barbeiros dos quais os gêneros mais importantes são Panstrongylus, Rhodinus e Triatoma. Essa zoonose atinge aproximadamente 10 milhões de pessoas em todo o mundo, principalmente na América Latina. Sabe-se que esse parasito apresenta grande variabilidade intraespecífica evidenciada por diferenças na patologia, virulência, constituição antigênica e habilidade de evasão à resposta imunológica e essa diversidade pode estar associada à sua adaptação e sobrevivência em diferentes hospedeiros. A diversidade patogênica, imunológica e morfológica inerente a esse flagelado dependem de fatores ainda indeterminados, como variação regional e individual da doença humana em infecções naturais e experimentais. Com o intuito de contribuir para ampliar o conhecimento sobre as populações de T. cruzi, propõe-se o estudo biológico, morfológico e molecular de duas cepas isoladas dos exemplares, Triatoma sordida (SI7) e Triatoma rubrovaria (QMM12) por Rosa et al. 2004; 2008 coletados nos Estados da Bahia e Rio Grande do Sul, respectivamente.

Síntese e avaliação biológica de novos compostos das séries LAPDESF FUR-PQ E LAPDESF FUR-TS contra Trypanosoma cruzi

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gastrin-Releasing Peptide Receptor Antagonism Induces Protection from Lethal Sepsis: Involvement of Toll-like Receptor 4 Signaling

In sepsis, toll-like receptor (TLR)-4 modulates the migration of neutrophils to infectious foci, favoring bacteremia and mortality. In experimental sepsis, organ dysfunction and cytokines released by activated macrophages can be reduced by gastrin-releasing peptide (GRP) receptor (GRPR) antagonist RC-3095. Here we report a link between GRPR and TLR-4 in experimental models and in sepsis patients. RAW 264.7 culture cells were exposed to lipopolysaccharide (LPS) or tumor necrosis factor (TNF)-alpha and RC-3095 (10 ng/mL), Male Wistar rats were subjected to cecal ligation and puncture (CLP), and RC-3095 was administered (3 mg/kg, subcutaneously); after 6 h, we removed the blood, bronchoalveolar lavage, peritoneal lavage and lung. Human patients with a clinical diagnosis of sepsis received a continuous infusion with RC-3095 (3 mg/kg, intravenous) over a period of 12 h, and plasma was collected before and after RC-3095 administration and, in a different set of patients with systemic inflammatory response syndrome (SIRS) or sepsis. GRP plasma levels were determined. RC-3095 inhibited TLR-4, extracellular-signal-related kinase (ERK)-1/2, Jun NH2-terminal kinase (JNK) and Akt and decreased activation of activator protein 1 (AP-1), nuclear factor (NF)-kappa B and interleukin (IL)-6 in macrophages stimulated by LPS. It also decreased IL-6 release from macrophages stimulated by TNF-alpha. RC-3095 treatment in CLP rats decreased lung TLR-4, reduced the migration of cells to the lung and reduced systemic cytokines and bacterial dissemination. Patients with sepsis and systemic inflammatory response syndrome have elevated plasma levels of GRP which associates with clinical outcome in the sepsis patients. These findings highlight the role of GRPR signaling in sepsis outcome and the beneficial action of GRPR antagonists in controlling the inflammatory response in sepsis through a mechanism involving at least inhibition of TLR-4 signaling. Online address: http://www.molmed.org doi: 10.2119/molmed.2012.00083

ROLE OF FOCAL ADHESION KINASE IN LUNG REMODELING OF ENDOTOXEMIC RATS

Despite significant advances in the care of critically ill patients, acute lung injury continues to be a complex problem with high mortality. The present study was designed to characterize early lipopolysaccharide (LPS)-induced pulmonary injury and small interfering RNA targeting focal adhesion kinase (FAK) as a possible therapeutic tool in the septic lung remodeling process. Male Wistar rats were assigned into endotoxemic group and control group. Total collagen deposition was performed 8, 16, and 24 h after LPS injection. Focal adhesion kinase expression, interstitial and vascular collagen deposition, and pulmonary mechanics were analyzed at 24 h. Intravenous injection of small interfering RNA targeting FAK was used to silence expression of the kinase in pulmonary tissue. Focal adhesion kinase, total collagen deposition, and pulmonary mechanics showed increased in LPS group. Types I, III, and V collagen showed increase in pulmonary parenchyma, but only type V increased in vessels 24 h after LPS injection. Focal adhesion kinase silencing prevented lung remodeling in pulmonary parenchyma at 24 h. In conclusion, LPS induced a precocious and important lung remodeling. There was fibrotic response in the lung characterized by increased amount in total and specific-type collagen. These data may explain the frequent clinical presentation during sepsis of reduced lung compliance, oxygen diffusion, and pulmonary hypertension. The fact that FAK silencing was protective against lung collagen deposition underscores the therapeutic potential of FAK targeting by small interfering RNA.

SMALL INTERFERING RNA TARGETING FOCAL ADHESION KINASE PREVENTS CARDIAC DYSFUNCTION IN ENDOTOXEMIA

Sepsis and septic shock are associated with cardiac depression. Cardiovascular instability is a major cause of death in patients with sepsis. Focal adhesion kinase (FAK) is a potential mediator of cardiomyocyte responses to oxidative and mechanical stress. Myocardial collagen deposition can affect cardiac compliance and contractility. The aim of the present study was to determine whether the silencing of FAK is protective against endotoxemia-induced alterations of cardiac structure and function. In male Wistar rats, endotoxemia was induced by intraperitoneal injection of lipopolysaccharide (10 mg/kg). Cardiac morphometry and function were studied in vivo by left ventricular catheterization and histology. Intravenous injection of small interfering RNA targeting FAK was used to silence myocardial expression of the kinase. The hearts of lipopolysaccharide-injected rats showed collagen deposition, increased matrix metalloproteinase 2 activity, and myocyte hypertrophy, as well as reduced 24-h +dP/dt and -dP/dt, together with hypotension, increased left ventricular end-diastolic pressure, and elevated levels of FAK (phosphorylated and unphosphorylated). Focal adhesion kinase silencing reduced the expression and activation of the kinase in cardiac tissue, as well as protecting against the increased collagen deposition, greater matrix metalloproteinase 2 activity, and reduced cardiac contractility that occur during endotoxemia. In conclusion, FAK is activated in endotoxemia, playing a role in cardiac remodeling and in the impairment of cardiac function. This kinase represents a potential therapeutic target for the protection of cardiac function in patients with sepsis.

Hypertonic saline solution reduces the inflammatory response in endotoxemic rats

OBJECTIVE: Volume replacement in septic patients improves hemodynamic stability. This effect can reduce the inflammatory response. The objective of this study was to evaluate the effect of 7.5% hypertonic saline solution versus 0.9% normal saline solution for volume replacement during an inflammatory response in endotoxemic rats. METHODS: We measured cytokines (serum and gut), nitrite, and lipid peroxidation (TBARS) as indicators of oxidative stress in the gut. Rats were divided into four groups: control group (C) that did not receive lipopolysaccharide; lipopolysaccharide injection without treatment (LPS); lipopolysaccharide injection with saline treatment (LPS + S); and lipopolysaccharide injection with hypertonic saline treatment (LPS + H). Serum and intestine were collected. Measurements were taken at 1.5, 8, and 24 h after lipopolysaccharide administration. RESULTS: Of the four groups, the LPS + H group had the highest survival rate. Hypertonic saline solution treatment led to lower levels of IL-6, IL-10, nitric oxide, and thiobarbituric acid reactive substances compared to 0.9% normal saline. In addition, hypertonic saline treatment resulted in a lower mortality compared to 0.9% normal saline treatment in endotoxemic rats. Volume replacement reduced levels of inflammatory mediators in the plasma and gut. CONCLUSION: Hypertonic saline treatment reduced mortality and lowered levels of inflammatory mediators in endotoxemic rats. Hypertonic saline also has the advantage of requiring less volume replacement.