951 resultados para Malocclusion Angle class III
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O objetivo deste trabalho foi avaliar a profundidade do palato e as dimensões da arcada dentária superior de indivíduos com má oclusão e diferentes tipos faciais. A amostra empregada neste estudo foi constituída por telerradiografias em norma lateral e modelos de estudo de 135 pacientes com más oclusões de Classe I (n = 45), Classe II (n = 45) e Classe III (n = 45) de ANGLE6 (1899), sendo 67 do sexo feminino e 68 do sexo masculino, com faixa etária entre 12 e 21 anos de idade, divididos igualmente em três grupos conforme o tipo facial apresentado: Braquifacial, Mesofacial e Dolicofacial. As medidas da distância intercaninos superiores, distância intermolares superiores e comprimento da arcada superior foram obtidas por meio de um paquímetro digital. A medida da profundidade do palato foi efetuada com o auxílio de um aparelho especialmente desenvolvido e adaptado a um paquímetro digital (ARMANDO et al.8, 2002), com a finalidade de obter-se a padronização desta medida. Os resultados obtidos demonstraram que, quanto ao tipo facial, houve diferença estatisticamente significante apenas para a medida da profundidade do palato, sendo que, os indivíduos braquifaciais apresentaram palato com menor profundidade (média = 18,18 mm), quando comparados aos indivíduos dolicofaciais (média = 19,52 mm). Quanto ao dimorfismo sexual, pudemos verificar que, os indivíduos do sexo masculino apresentaram médias da distância intermolares superiores (51,36 mm) e da profundidade do palato (19,61 mm) aumentadas, de forma significante, em relação às médias obtidas para o sexo feminino (50,15 mm e 18,37 mm para as medidas da distância intermolares e da profundidade do palato, respectivamente). Avaliando o tipo de má oclusão, pudemos constatar que houve diferença estatisticamente significante apenas para a medida do comprimento da arcada, sendo que, indivíduos com má oclusão de Classe II apresentaram arcadas dentárias superiores com maior comprimento ântero-posterior (média = 31,23 mm) que indivíduos com má oclusão de Classe III (média = 29,64 mm). Entretanto, a média da medida comprimento da arcada encontrada para o grupo Classe I (30,52 mm) não apresentou diferença estatisticamente significante quando comparada às médias obtidas para os grupos Classe II e Classe III.
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Realizou-se um estudo comparativo do número de pontos de contato oclusais na posição de máxima intercuspidação habitual em uma amostra composta por 14 pacientes leucodermas, sendo 9 do sexo feminino e 5 do sexo masculino, com máoclusão de Classe II, divisão 1a de Angle, tratados ortodonticamente pela técnica de Edgewise, com extrações dos 4 primeiros pré-molares. Estes pontos foram registrados em dois tempos: T1 - ao final da fase de contenção superior e T2 - após um período médio de 5,2 anos. A contagem dos contatos oclusais foram realizadas nos arcos superior e inferior, separadamente, para as regiões anterior e posteriores. Depois da análise estatística, pôde-se concluir que não houve diferença estatisticamente significante entre o número médio de contatos oclusais nos diferentes períodos estudados.(AU)
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O objetivo deste estudo retrospectivo foi comparar a eficiência oclusal do tratamento ortopédico com os aparelhos funcionais Regulador de Função Fränkel-2 e Bionator de Balters em um estágio de desenvolvimento dental diferente e comparar com um grupo controle. A amostra constituiu-se de 45 registros de documentações, pertencentes ao arquivo do programa de pós-graduação em Odontologia, área de concentração Ortodontia, da Universidade Metodista de São Paulo, com má oclusão inicial de Classe II bilateral, divisão 1, sendo 15 pacientes provenientes do grupo tratados com Bionator (grupo 1) com média de idade incial de 8,56 anos e com 80% dos casos em um estágio de desenvolvimento dental-2 (DS 2), 15 pacientes tratados com RF-2 (grupo 2) com média de idade inicial de 10,71 anos e com 80% dos casos em um estágio de desenvolvimento dental-3 (DS 3), e 15 pacientes controle (grupo 3) com media de idade incial de 10,03 anos e com estágio de desenvolvimento dental compatível com os grupos 1 e 2. Os grupos foram divididos em duas fases, de acordo com o período de avaliação: T1:início de tratamento e T2: final de tratamento, totalizando 90 pares de modelos. As avaliações oclusais foram realizadas em modelos de gesso, utilizando o Índice PAR com auxílio da régua PAR e de um paquímetro digital devidamente calibrado. Para comparação entre os três grupos foi utilizado Análise de Variância a um critério e em seguida o Teste de Tukey. A severidade da má oclusão (PAR Inicial) foi semelhante em ambos os grupos, porém, o PAR final apresentou uma diferença estatisticamente significante onde o percentual de redução do índice PAR para o grupo 1 foi de 20,72%, para o grupo 2 foi de 60,06% e no grupo 3 não houve alteração significante do valor do Índice PAR. O presente estudo conclui que o tratamento da má oclusão de Classe II, 1a divisão é mais eficiente quando iniciado no estágio de desenvolvimento dental 3 (DS 3) do que no estágio de desenvolvimento dental 2 (DS2). Além disso, ressalta-se a importância do uso mais prolongado do aparelho ortopédico, já que os pacientes do grupo 2 apresentaram melhores resultados oclusais.(AU)
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O objtivo deste estudo pros
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O objetivo deste estudo prospectivo foi avaliar os efeitos do aparelho Forsus® nos incisivos centrais superiores e inferiores. A amostra constituiu-se de 22 tomografias computadorizadas de 11 pacientes (sexo masculino e feminino) idade média de 15,8 anos com má oclusão de Classe II que foram tratados com o aparelho Forsus® na clínica do programa de pós-graduação em Odontologia, área de concentração Ortodontia, da Universidade Metodista de São Paulo. As tomografias foram obtidas em dois momentos T1 (final de nivelamento e antes da instalação do Forsus® e T2 (remoção do Forsus®). Para avaliar a distância do ápice até a tábua óssea, as imagens a serem examinadas foram obtidas com o auxílio do viewer do próprio i-CAT® , o iCATVision® e examinadas com o CorelDRAW X5® já para as medidas cefalométricas IMPA e 1.PP as imagens cefalométricas ortogonais foram obtidas em proporção 1:1 com auxílio do software Dolphin 3D® (Dolphin Imaging and Management Solutions, Chatsworth, EUA) e em seguida examinadas com o software Radiocef Studio 2 (Radio Memory, Belo Horizonte, Brasil). Para a obtenção do erro intra-examinador foi feito o teste t de Student pareado para o erro sistemático e a fórmula de DAHLBERG para estimar a ordem de grandeza dos erros casuais e na análise estatística dos resultados utilizou-se: o teste t para a determinação das diferenças entres as fases de observação e o teste de correlação de Pearson para avaliar a correlação entres as alterações. Observou-se: um aumento significativo (p<0,05) tanto no IMPA quanto no 1.PP, aproximação do ápice dos incisivos inferiores da tábua óssea lingual, aproximação do ápice dos incisivos superiores da tábua óssea vestibular, uma correlação negativa muito forte entre o IMPA e a distância do ápice do incisivo até a tábua óssea lingual e uma correlação negativa moderada entre 1.PP e a distância do ápice do incisivo até a tábua óssea vestibular. Sendo assim o aparelho Forsus® no tratamento da Classe II teve como efeito: vestibularização significativa dos incisivos centrais inferiores, uma verticalização significativa dos incisivos centrais superiores, aproximação do ápice dos incisivos inferiores da cortical óssea lingual e aproximação do ápice dos incisivos superiores da cortical óssea vestibular.
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El objetivo de este estudio fue determinar la relación cráneo cervical en pacientes clases I, II y III esqueletal entre 9 y 18 años de edad, mediante radiografías cefálicas laterales de un centro radiológico de la ciudad de Cuenca, utilizando el análisis cráneo cervical propuesto por Rocabado. Materiales y métodos: Fueron analizadas 161 radiografías cefálicas laterales digitales, de ambos sexos, con edad promedio de 12.3 años (DE± 2.4). Se incluyeron radiografías de individuos con dentición mixta y permanente, sin tratamiento ortodóncico y en donde se observe hasta la sexta vértebra cervical. Fueron excluidas las radiografías de pacientes con mordida abierta, traumatismos maxilofaciales y radiografías de mala calidad. Las telerradiografías fueron analizadas mediante el programa cefalométrico Nemoceph NX, donde se determinó el patrón esqueletal mediante los ángulos SNA, SNB, ANB y APDI. La evaluación de la postura cervical, se realizó mediante el análisis cráneo cervical propuesto por Rocabado. Se obtuvo el índice de concordancia (ICC=0.94). Mediante estadística descriptiva se analizaron las relaciones entre variables usando la prueba de Chi cuadrado y T de Student. Resultados: Se encontró mayor rotación posterior de cráneo en clase I y II esqueletal, encontrándose diferencias estadísticamente significativas respecto al ángulo cráneo vertebral entre hombres y mujeres en individuos clase II esqueletal. Las mujeres presentaron mayor rotación posterior de cráneo a diferencia de los hombres. (p=0.004). En clase III se encontró una relación normal. El espacio suboccipital en las tres clases esqueletales se presento con normalidad. No se encontró diferencia significativa respecto a la edad. Conclusiones: La relación cráneo cervical se presenta con una tendencia a la rotación posterior de cráneo, influida fuertemente por el sexo del individuo. El espacio suboccipital es normal en clase I y II esqueletal y con tendencia al aumento en clase III.
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We report a theoretical study of the multiple oxidation states (1+, 0, 1−, and 2−) of a meso,meso-linked diporphyrin, namely bis[10,15,20-triphenylporphyrinatozinc(II)-5-yl]butadiyne (4), using Time-Dependent Density Functional Theory (TDDFT). The origin of electronic transitions of singlet excited states is discussed in comparison to experimental spectra for the corresponding oxidation states of the close analogue bis{10,15,20-tris[3‘,5‘-di-tert-butylphenyl]porphyrinatozinc(II)-5-yl}butadiyne (3). The latter were measured in previous work under in situ spectroelectrochemical conditions. Excitation energies and orbital compositions of the excited states were obtained for these large delocalized aromatic radicals, which are unique examples of organic mixed-valence systems. The radical cations and anions of butadiyne-bridged diporphyrins such as 3 display characteristic electronic absorption bands in the near-IR region, which have been successfully predicted with use of these computational methods. The radicals are clearly of the “fully delocalized” or Class III type. The key spectral features of the neutral and dianionic states were also reproduced, although due to the large size of these molecules, quantitative agreement of energies with observations is not as good in the blue end of the visible region. The TDDFT calculations are largely in accord with a previous empirical model for the spectra, which was based simplistically on one-electron transitions among the eight key frontier orbitals of the C4 (1,4-butadiyne) linked diporphyrins.
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Aim: To review the management of heart failure in patients not enrolled in specialist multidisciplinary programs. Method: A prospective clinical audit of patients admitted to hospital with either a current or past diagnosis of heart failure and not enrolled in a specialist heart failure program or under the direct care of the cardiology unit. Results: 81 eligible patients were enrolled (1 August to 1 October 2008). The median age was 81 9.4 years and 48% were male. Most patients (63%) were in New York Heart Association Class II or Class III heart failure. On discharge, 59% of patients were prescribed angiotensin converting enzyme inhibitors and 43% were prescribed beta-blockers. During hospitalisation, 8.6% of patients with a past diagnosis of heart failure were started on an angiotensin converting enzyme inhibitor and 4.9% on a beta-blocker. There was evidence of suboptimal dosage on admission and discharge for angiotensin converting enzyme inhibitors (19% and 7.4%) and beta-blockers (29% and 17%). The results compared well with international reports regarding the under-treatment of heart failure. Conclusion: The demonstrated practice gap provides excellent opportunities for the involvement of pharmacists to improve the continuation of care for heart failure patients discharged from hospital in the areas of medication management review, dose titration and monitoring.
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13.1 Drugs for cardiac arrhythmias 13.1.1 Introduction to cardiac arrhythmias 13.1.2 Cardiac action potentials 13.1.3 Mechanisms of cardiac arrhythmias 13.1.3 Class I 13.1.4 Class II 13.1.5 Class III 12.1.6 Class IV 13.1.7 Amiodarone 13.1.8 Adenosine 13.2 Antithrombotic drugs 13.2.1 Thrombus formation 13.2.2 Platelet aggregation and anti-platelet drugs 13.2.3 Coagulation 13.2.4 Anticoagulants 13.2.5 Fibrinolysis and fibrinolytics 13.3. Lipid modulating drugs 13.3.1 Cholesterol 13.3.2 Statins 13.3.3 Fibric acid derivatives 13.3.4 Ezetimibe
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Objective. To localize the regions containing genes that determine susceptibility to ankylosing spondylitis (AS). Methods. One hundred five white British families with 121 affected sibling pairs with AS were recruited, largely from the Royal National Hospital for Rheumatic Diseases AS database. A genome-wide linkage screen was undertaken using 254 highly polymorphic microsatellite markers from the Medical Research Council (UK) (MRC) set. The major histocompatibility complex (MHC) region was studied more intensively using 5 microsatellites lying within the HLA class III region and HLA-DRB1 typing. The Analyze package was used for 2-point analysis, and GeneHunter for multipoint analysis. Results. When only the MRC set was considered, 11 markers in 7 regions achieved a P value of ≤0.01. The maximum logarithm of odds score obtained was 3.8 (P = 1.4 x 10-5) using marker D6S273, which lies in the HLA class III region. A further marker used in mapping of the MHC class III region achieved a LOD score of 8.1 (P = 1 x 10-9). Nine of 118 affected sibling pairs (7.6%) did not share parental haplotypes identical by descent across the MHC, suggesting that only 31% of the susceptibility to AS is coded by genes linked to the MHC. The maximum non-MHC LOD score obtained was 2.6 (P = 0.0003) for marker D16S422. Conclusion. The results of this study confirm the strong linkage of the MHC with AS, and provide suggestive evidence regarding the presence and location of non-MHC genes influencing susceptibility to the disease.
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Among the human diseases that result from chromosomal aberrations, a de novo deletion in chromosome 11p13 is clinically associated with a syndrome characterized by Wilms' tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR). Not all genes in the deleted region have been characterized biochemically or functionally. We have recently identified the first Class III cyclic nucleotide phosphodiesterase, Rv0805, from Mycobacterium tuberculosis, which biochemically and structurally belongs to the superfamily of metallophosphoesterases. We performed a large scale bioinformatic analysis to identify orthologs of the Rv0805 protein and identified many eukaryotic genes that included the human 239FB gene present in the region deleted in the WAGR syndrome. We report here the first detailed biochemical characterization of the rat 239FB protein and show that it possesses metallophosphodiesterase activity. Extensive mutational analysis identified residues that are involved in metal interaction at the binuclear metal center. Generation of a rat 239FB protein with a mutation corresponding to a single nucleotide polymorphism seen in human 239FB led to complete inactivation of the protein. A close ortholog of 239FB is found in adult tissues, and biochemical characterization of the 239AB protein demonstrated significant hydrolytic activity against 2',3'-cAMP, thus representing the first evidence for a Class III cyclic nucleotide phosphodiesterase in mammals. Highly conserved orthologs of the 239FB protein are found in Caenorhabditis elegans and Drosophila and, coupled with available evidence suggesting that 239FB is a tumor suppressor, indicate the important role this protein must play in diverse cellular events.
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Guanylyl cyclases (GCs) are enzymes that generate cyclic GMP and regulate different physiologic and developmental processes in a number of organisms. GCs possess sequence similarity to class III adenylyl cyclases (ACs) and are present as either membrane-bound receptor GCs or cytosolic soluble GCs. We sought to determine the evolution of GCs using a large-scale bioinformatic analysis and found multiple lineage-specific expansions of GC genes in the genomes of many eukaryotes. Moreover, a few GC-like proteins were identified in prokaryotes, which come fused to a number of different domains, suggesting allosteric regulation of nucleotide cyclase activity Eukaryotic receptor GCs are associated with a kinase homology domain (KHD), and phylogenetic analysis of these proteins suggest coevolution of the KHD and the associated cyclase domain as well as a conservation of the sequence and the size of the linker region between the KHD and the associated cyclase domain. Finally, we also report the existence of mimiviral proteins that contain putative active kinase domains associated with a cyclase domain, which could suggest early evolution of the fusion of these two important domains involved in signa transduction.
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Background/Aim There is a 70% higher age-adjusted incidence of heart failure (HF) amongst Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths than non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community healthcare to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. Methods This study was conducted in two phases and utilised a mixed methods approach (qualitative and quantitative). Phase 1 of this study used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. A HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Results - Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this and of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. - Phase 2: Five Aboriginal participants, mean age 61.6 ± 10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0 ± 6.7% to 58.0 ± 9.7%, a 20.8% increase and results of the self-care index indicated that the biggest change was in patient confidence for self-care with a 95% increase in confidence score (46.7 ± 16.0 to 91.1 ± 11.5). Changes in management and maintenance scores varied between9275 patients. Conclusion By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.
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This study aimed at elucidating real-life aspects of restorative treatment practices. In addition, dentists' views and perceptions of and variation in restorative treatment practices with respect to dentist-related factors were evaluated. Reasons for placement and replacement of restoration, material selection, posterior restoration longevity, and the use of local anesthesia were assessed on two cross-sectional data sets. Data from the Helsinki Public Dental Service (PDS) included details on 3057 restorations performed by dentists (n=134) during routine clinical work in 2001. The other PDS data from Vantaa were based on 205 patient records of young adults containing information on 1969 restorations investigated retrospectively from 1994-1996 backwards; 51 dentists performed the restorations. In addition, dentists’ self-reported use of local anesthesia and estimates of restoration longevity were investigated by means of a nationwide questionnaire sent to 592 general dental practitioners selected by systematic sampling from the membership list of the Finnish Dental Association in 2004. All data sets included some background information on dentists such as gender, year of birth or graduation, and working sector. In PDS in 2001, primary caries was the reason for placement of restoration more often among patients aged under 19 years than among older patients (p<0.001). Among patients over 36 years of age, replacements represented the majority. Regarding dentist-related factors, replacements of restorations were made by younger dentists more frequently than by older dentists (p<0.001). In PDS in 1994-1996, the replacement rate of posterior restorations was greater among female dentists than among male dentists (p=0.01), especially for amalgams (p=0.008). The mean age of replaced posterior restoration among young adults was 8.9 (SD 5.2) years for amalgam and 2.4 (SD 1.4) years for tooth-colored restorations, the actual replacement rate for all existing posterior restorations being 7% in PDS in 1994-1996. Of all restorative materials used, a clear majority (69%) were composites in PDS in 2001. Local anesthesia was used in 48% of cases and more frequently for older patients (55%) than for patients aged under 13 years (35%) (p<0.001). Younger dentists more often used local anesthesia for primary restoration than did the older dentists (p<0.001), especially for primary teeth (p=0.005). Working sector had an impact on dentists’ self-reported use of local anesthesia and estimates of restoration longevity; public sector dentists reported using local anesthesia more frequently than private sector dentists for Class II (p=0.04) and for Class III restorations (p=0.01). Private sector dentists gave longer estimates of posterior composite longevity than public sector dentists (p=0.001). In conclusion, restorative treatment practices seem to vary according to patient age and also dentist-related factors. Replacements of restorations are common for adults. For children, clear underuse of local anesthesia prevails.
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Lignin is a complex plant polymer synthesized through co-operation of multiple intracellular and extracellular enzymes. It is deposited to plant cell walls in cells where additional strength or stiffness are needed, such as in tracheary elements (TEs) in xylem, supporting sclerenchymal tissues and at the sites of wounding. Class III peroxidases (POXs) are secreted plant oxidoreductases with implications in many physiological processes such as the polymerization of lignin and suberin and auxin catabolism. POXs are able to oxidize various substrates in the presence of hydrogen peroxide, including lignin monomers, monolignols, thus enabling the monolignol polymerization to lignin by radical coupling. Trees produce large amounts of lignin in secondary xylem of stems, branches and roots. In this study, POXs of gymnosperm and angiosperm trees were studied in order to find POXs which are able to participate in lignin polymerization in developing secondary xylem i.e. are located at the site of lignin synthesis in tree stems and have the ability to oxidize monolignol substrates. Both in the gymnosperm species, Norway spruce and Scots pine, and in the angiosperm species silver birch the monolignol oxidizing POX activities originating from multiple POX isoforms were present in lignifying secondary xylem in stems during the period of annual growth. Most of the partially purified POXs from Norway spruce and silver birch xylem had highest oxidation rate with coniferyl alcohol, the main monomer in guaiacyl-lignin in conifers. The only exception was the most anionic POX fraction from silver birch, which clearly preferred sinapyl alcohol, the lignin monomer needed in the synthesis of syringyl-guaiacyl lignin in angiosperm trees. Three full-length pox cDNAs px1, px2 and px3 were cloned from the developing xylem of Norway spruce. It was shown that px1 and px2 are expressed in developing tracheids in spruce seedlings, whereas px3 transcripts were not detected suggesting low transcription level in young trees. The amino acid sequences of PX1, PX2 and PX3 were less than 60% identical to each other but showed up to 84% identity to other known POXs. They all begin with predicted N-terminal secretion signal (SS) peptides. PX2 and PX3 contained additional putative vacuolar localization determinants (VSDs) at C-terminus. Transient expression of EGFP-fusions of the SS- and VSD-peptides in tobacco protoplasts showed SS-peptides directed EGFP to secretion in tobacco cells, whereas only the PX2 C-terminal peptide seems to be a functional VSD. According to heterologous expression of px1 in Catharanthus roseus hairy roots, PX1 is a guaicol-oxidizing POX with isoelectric point (pI) approximately 10, similar to monolignol oxidizing POXs in protein extracts from Norway spruce lignifying xylem. Hence, PX1 has characteristics for participation to monolignol dehydrogenation in lignin synthesis, whereas the other two spruce POXs seem to have some other functions. Interesting topics in future include functional characterization of syringyl compound oxidizing POXs and components of POX activity regulation in trees.