Mandible metastasis as the first sign from primary adenocarcinoma of the lung

Adenocarcinoma of the lung that metastasizes to the mandible is very uncommon; only a few cases have been described in the English-language literature. This article presents a metastasis from adenocarcinoma of the lung affecting the mandible of a 64-year-old woman, in which the first discovered metastatic lesion was detected before the primary tumor. The immunoreactivity for human thyroid transcription factor-1 (TTF-1) in the oral lesion was essential for determining the site and type of the primary tumor, as the patient showed no clinical or radiographic evidence of a tumor in the thyroid gland. After the primary tumor in the lung was diagnosed, radiotherapy and chemotherapy were initiated; unfortunately, the patient died two months after the start of treatment. This article emphasizes the importance of a well-conducted examination for diagnosing metastatic oral lesions.

Bone healing in critical-size defects treated with bioactive glass/calcium sulfate: A histologic and histometric study in rat calvaria

Objective: The purpose of this study was to analyze histologically the influence of bioactive glass (BG) with or without a calcium sulfate (CS) barrier on bone healing in surgically created critical-size defects (CSD) in rat calvaria. Material and methods: A CSD was made in each calvarium of 48 rats. They were divided into three groups: C (control): blood clot only; BG: defect filled with BG; and BG/CS: defect filled with BG covered by a CS barrier. Animals were euthanized at 4 or 12 weeks. Formation of new bone was evaluated histomorphometrically. Results: No defect completely regenerated with bone. BG particles were observed in Groups BG and BG/CS at both periods of analysis. The thickness throughout the healing area in Groups BG and BG/CS was similar to the original calvarium, while Group C presented a thin connective tissue in the center of the defect in both periods of analysis. At 4 weeks, Groups C and BG/CS presented significantly more bone formation than Group BG. No significant differences were found between Groups C and BG/CS. At 12 weeks, no significant differences in the amount of bone formation were observed among the three groups. When comparing 4 and 12 weeks, there was a significant increase in new bone formation within groups BG and BG/CS, but not C. Conclusion: BG particles, used with or without a CS barrier, maintained the volume and contour of the area grafted in CSD. However, they did not lead to a significant difference in bone formation when compared with control at 12 weeks post-operative. © 2007 Blackwell Munksgaard.

Ectrópio palpebral em portador da síndrome de Down e conjuntivite alérgica: Relato de caso

This is a case report of a patient with Down's syndrome with an important mechanical ectropion and elongation of the lower lid related to chronic allergic conjunctivitis, besides cataract and keratoconus. The tarsal strip technique and ressection of redundant and thick conjunctiva was the surgical approach chosen for this case. Functional and cosmetic outcomes were considered satisfactory.

Levantamento gravimétrico na região de Franca - SP e delfinópolis - MG, no reconhecimento e delimitação de feições estruturais (Zonas de Sutura)

This paper presents the results of a geophysical study carried out in northeastern São Paulo State and southwestern Minas Gerais State over an area 80 km wide and 97.5 km long in SE Brazil. The Bouguer anomaly map, and geological and structural data allowed to identify three different gravity domains - crustal blocks limited by major discontinuities -related to the structural pattern of the area. These discontinuities were interpreted as geosuture zones underlying the Paraná Basin sediments which have extensions in the Pre-cambrian Basement. The crustal discontinuities named Alterosa and Ribeirão Preto may be seen as A - type collision sutures in a triple junction arramgement. Two prominent linear anomalies are recognized in the Bouguer anomaly map, as well as the limit between the Brasilia and São Paulo crustal blocks or paleoplates. The Alterosa suture zone trends NW-SE while the Ribeirão Preto suture has a NE-SW direction. The Bouguer anomaly map provides subsidies and information on new concepts and theories leading to the refinement of tectonic models.

Homogenous demineralized dentin matrix for application in cranioplasty of rabbits with alloxan-induced diabetes: Histomorphometric analysis

Purpose: The aim of this work was to evaluate the bone-repair process after implantation of homogenous demineralized dentin matrix (HDDM) slices in surgical defects created in the parietal bones of rabbits with alloxan-induced diabetes. Materials and Methods: Forty-eight rabbits were selected and divided into 4 groups of 12 rabbits: the control group, diabetic rabbits (D), diabetic rabbits with a PTFE barrier (D-PTFE), and diabetic rabbits with a PTFE barrier and with slices of homogenous demineralized dentin matrix (D-PTFE+HDDM). The diabetic animals received a single dose of alloxan monohydrate (90 mg/kg) intravenously on the marginal ear vein, and their blood glucose was verified daily. The rabbits were sacrificed after 15, 30, 60, and 90 days. The histologic findings show both better bone structure and significantly greater bone density, as determined by histomorphometric analysis, for the D-PTFE + HDDM group than for the other 3 groups (P < .01). It was also observed that the mean bone density increased gradually from 15 to 90 days (except in the D-PTFE group). Conclusion: It was concluded that the HDDM was biocompatible with the bone repair of diabetic rabbits and that HDDM slices stimulated bone tissue formation. Facilitation of bone repair with HDDM could be useful in diabetic patients.

Ossificação da sutura palatina mediana após o procedimento de expansão rápida da maxila: Estudo radiográfico

Objective: the current study aims at following up radiographically the evolution of the midpalatal suture during the expansion procedure since the opening of the suture until bone formation. Methods: the sample comprised 38 patients in the mixed dentition stage submitted to the rapid palatal expansion protocol of the Hospital for Rehabilitation of Craniofacial Anomalies. Results: it was observed an individual variation on the period of bone ossification of the midpalatal suture, which justifies the radiographic follow-up as determinant for the appliance removal. Due to long-term post-treatment stability, the expander should be removed after the new suture is completely formed. Conclusions: the findings show that it is necessary more than three months for the complete reorganization of the midpalatal suture during the passive phase of the rapid palatal expansion.

Immunohistochemical, tomographic and histological study on onlay iliac grafts remodeling

The information concerning the molecular events taking place in onlay bone grafts are still incipient. The objective of the present study is to correlate the effects of perforation of resident bone bed on (1) the timing of onlay autogenous graft revascularization; (2) the maintenance of volume/density of the graft (assessed through tomography); and (3) the occurrence of bone remodeling proteins (using immunohistochemistry technique) delivered in the graft. Thirty-six New Zealand White rabbits were subjected to iliac crest onlay bone grafting on both sides of the mandible. The bone bed was drill-perforated on one side aiming at accelerating revascularization, whereas on the other side it was kept intact. After grafts fixation and flaps suture all animals were submitted to tomography on both mandible sites. Six animals were sacrificed, respectively, at 3, 5, 7, 10, 20 and 60 days after surgery. A second tomography was taken just before sacrifice. Histological slides were prepared from each grafted site for both immunohistochemistry analysis [osteopontin, osteocalcin, type I collagen and vascular endothelial growth factor (VEGF) anti-bodies] and histometric analysis. The values on bone volume measured on tomography showed no statistic significance (P≥0.05) between perforated and intact sites. Grafts placed on perforated beds showed higher bone density values compared with non-perforated ones at 3 days (P≤0.05). This correlation was inverted at 60 days postoperatively. The findings from VEGF labeling revealed a tendency for earlier revascularization in the perforated group. The early revascularization of bone grafts accelerated the bone remodeling process (osteocalcin, type I collagen and osteopontin) that led to an increased bone deposition at 10 days. The extended osteoblast differentiation process at intermediate stages in the perforated group cooperated for a denser bone at 60 days. © 2008 Blackwell Munksgaard.

Bone regeneration in cranioplasty and clinical complications in rabbits with alloxan-induced diabetes

This research evaluated the bone repair process in surgical defects created on the parietal bones of diabetic rabbits using the guided bone regeneration technique to observe the effects of alloxan in the induction of diabetes mellitus. Twenty-four adult rabbits were divided into three study groups: control (C), diabetic (D) and diabetic associated to polytetrafluoroethylene (PTFE) membrane (D-PTFE). For diabetes induction the animals received one dose of monohydrated alloxan (90 mg/kg) by intravenous administration in the auricular or femoral vein. In group D-PTFE the membrane covered both the floor and the surface of the bone defect. In groups D and C, the bone defect was filled up with blood clot. The specimens were fixed in 10% formol and prepared for histomorphometric analysis. The results showed that the 90 mg/kg dose of monohydrate alloxan was sufficient to promote diabetes mellitus when administered in the auricular vein. Bone regeneration was slower in the diabetic group when compared with the control and diabetic-PTFE groups, but there was no significant statistical difference between the two experimental groups (D and D-PTFE). The oral and general clinical complications among the diabetics were weight loss, polyuria, polyphagia and severe chronic gingivitis.

Optical density of bone repair after implantation of homogenous demineralized dentin matrix in diabetic rabbits

This research evaluated the bone repair process after implantation of homogenous demineralized dentin matrix (HDDM) in surgical defects in the parietal bone of rabbits with alloxan-induced diabetes, using a polytetrafluorethylene (PTFe) barrier for guided bone regeneration. Thirty-six rabbits were used and divided into four groups: control (C, n = 12), diabetic (D, n = 12, left parietal bone), diabetic with PTFe (DPTFe, same 12 rabbits, right parietal bone), and diabetic with PTFe associated to HDDM (D-PTFe+HDDM, n = 12). Bone defects were created in the parietal bone of the rabbits and the experimental treatments were performed, where applicable. The rabbits were sacrificed after 15, 30, 60 and 90 days. The bone defects were examined radiographically and by optical density (ANOVA and Tukey test, p < .05). The radiographic findings showed that the D-PTFe+HDDM group presented greater radiopacity and better trabecular bone arrangement when compared to that of the C, D and D-PTFe groups. The statistical analysis showed significant differences in the optical density of the newly formed bone among the studied groups. It was possible to conclude that HDDM was biocompatible in diabetic rabbits.

Immunohistochemical, tomographic and histological study on onlay bone graft remodeling. Part II: Calvarial bone

Objectives: Little information is available on the molecular events that occur during graft incorporation over time. The calvarial bone (Cb) grafts have been reported to produce greater responses compared with other donor regions in maxillofacial reconstructions, but the scientific evidences for this are still lacking. The objectives of this study are (1) to study the morphological pattern of Cb onlay bone grafts and compare them with the biological events through immunohistochemical responses and (2) to establish the effects of perforations in maintaining the volume and bone density of the receptor bed. Material and methods: Sixty New Zealand White rabbits were submitted to Cb onlay bone grafts on the mandible. In 30 rabbits, the receptor bed was perforated (perforated group), while for the remaining animals the bed was kept intact (non-perforated group). Six animals from each group were sacrificed at 5, 7, 10, 20 and 60 days after surgery. Histological sections from the grafted area were prepared for immunohistochemical and histological analyses. Immuno-labeling was found for proteins Osteoprotegerin (OPG), receptor activator of nuclear factor-κβ ligand (RANKL), alkaline phosphatase (ALP), osteopontin (OPN), vascular endothelial growth factor (VEGF), tartrate-resistant acid phosphatase (TRAP), Type I collagen (COL I) and osteocalcin (OC). The tomography examination [computerized tomography (CT) scan] was conducted just after surgery and at the sacrifice. Results: The histological findings revealed that the perforations contributed to higher bone deposition during the initial stages at the graft-receptor bed interface, accelerating the graft incorporation process. The results of the CT scan showed lower resorption for the perforated group (P≤0.05), and both groups showed high bone density rates at 60 days. This set of evidences is corroborated by the immunohistochemical outcomes indicating that proteins associated with revascularization and osteogenesis (VEGF, OPN, TRAP and ALP) were found in higher levels in the perforated group. Conclusions: These findings indicate that the bone volume of calvarial grafts is better maintained when the receptor bed is perforated, probably resulting from more effective graft revascularization and greater bone deposition. The process of bone resorption peaked between 20 and 60 days post-operatively in both groups although significantly less in the perforated group. © 2009 John Wiley & Sons A/S.

Osteologia craniana de Nyctibiidae (Aves, Caprimulgiformes)

The Potoos form an exclusively neotropical family of nocturnal birds distributed throughout Central and South America, except Chile, and reaching their highest diversity in the Amazon region. The seven currently recognized species are certainly among the most poorly known birds of this region. They are characterized by a distinctive mimicry of vegetal trunks, where they remain almost motionless during daytime. For this reason, their nocturnal and cryptic habits make them exceedingly difficult to study. Published accounts on behavior and natural history of the family are scarce and contributions regarding its anatomy are rare. Here we sample six of the seven currently recognized species of Nyctibiidae, including Nyctibius grandis, N. aethereus, N. griseus, N. jamaicensis, N. leucopterus and N. bracteatus, in order to conduct a detailed and illustrated description of the skull and jaw osteology. High interspecific variation in skull osteology was observed in the family. Species of this family possess a highly modified skull, adapted to their life habits, which shelters their well developed eyes and permits a large mouth opening. The bones that form the palate structure exhibit a dorsoventral flattening, particularly in the pterigoid and parasphenoid bones, with the palatine bone being a broadly developed, wing-shaped structure. In the maxilar region, near the jugal arch, there is a tooth-like projection, unique among birds, which may assist in the retention of prey upon capture. The vomer bone is highly variable within the family, showing varying numbers of rostral projections amongst species. The broad occipital region exhibits large spacing between the quadrate bones, which are vertically disposed and possess a reduced processus orbitalis. The mandible, which is flexible and elastic, has an extremely short symphyseal region and sindesmotic joints in both mandibular rami. As a family, potoos possess a highly specialized skull which provides insight into the relationship between the form of the structures and the feeding habits of the species. Furthermore, the large interspecific variation in skull morphology emphasizes the needs for taxonomic revision within the family, which at present is lumped into a single genus.

Assessment of manipulation accuracy of digitized occlusal radiographic images--sub and over exposure.

The aim of this study was to evaluate whether digitized images obtained from occlusal radiographs taken with low or over dose of radiation could be improved with the aid of computer software for digital treatment. Thirteen occlusal radiographs of a dry skull were taken employing 13 different exposure times. The radiographs were digitized and then manipulated with the program for image editing. 143 evaluations were performed by specialists in dental radiology who classified radiographs as appropriate or not appropriate for interpretation. Test Z was used for statistical analysis of the data and the results showed that it is possible to manipulate digitized radiographic images taken with 75% of the ideal exposure time and to make them suitable for interpretation and diagnosis. Conversely, it was concluded that the over exposed images, 57.50% above the standard exposure time, were inadequate.

Arranjos configurados pelos nervos do plexo braquial no urubu (Coragyps atratus foetens - Linnaeus, 1758)

The anatomical study of the origin and distribution of brachial plexus in vulture (Coragyps atratus foetens) was performed in 14 animals, adults, males and females, deriving of the region of Araçatuba (SP). After fixed in watery solution of formaldehyde 10,00%, became dissected bilateral of the origin of the brachial plexus, and yours distribution. The analysis allowed verify that brachial plexus of vulture, four root possess, which originate from the ventral branches of cervical spinal nerves eleven (C11), twelve (C12) and thirteen (C13) and of the ventral branches of thoracic spinal nerve one (T1) and (T2) in both sides (100%). The first root part of C11 in the right and left side, and of the edge skull of the dorsal lace the nerves subescapular, subcoracoescapular e supracoracóide in both antímeros (100%). As the root originates from C12 in both sides, giving origin to the dorsal lace, giving the axilar, radial and anconeal nerves (100%). The third root of plexus originates solely from C13 (100%) and the root of T1 in both sides (100%). The roots of C12, C13 and T1 was united the ventral lace originates, which breaks the nerves to medianoulnar that divided in medium and to ulnar and the pectoral nerves (100%). T2 emits filaments that join it root nervous of T1, being one filament (35,55%) and two filaments (64,29%) in side right, while that in the left one filament (42,85%), two filaments (50%) and three filaments (7,15%).

Neurorrafia do ramo bucal dorsal do nervo facial em coelhos com proteção de segmento intestinal alógeno

18 rabbits, New Zealand, males, adults were used for clinical and histological evaluation of repair dorsal buccal branch of facial nerve after 15, 30 and 60 days postoperatively (PO). The animals were divided into two groups for transection and 10-0 nylon monofilament epineural suture of buccal branch. In animals in Group I, the nerve was coated with protection of jejunum allograft preserved in glycerin 98% and in group II was applied epineural suture. Both groups occurred the return of movement of the upper lip from the eighth week. There was infiltrated cellular and giant cells with fibrosis unsystematic and collagen fibers of the allograft jejunum joing to the connective tissue. At 15 and 30 days of PO, the distal nerve stumps of both groups were found with degeneration wallerian and in 60 days, regenerated fibers. The repair of the dorsal buccal branch of facial nerve with the allograft wasn't significantly different between the control rabbits as to the assessment of histological and functional recovery.

Incidence of the ossified pterygoalar ligament in Brazilian human skulls and its clinical implications

The ossified pterygoalar ligament is formed between the lateral lamina of the pterygoid process and the infratemporal surface of the sphenoid bone or its greater wing and was not connected to the sphenoid spine. The aim of this study was to evaluate the incidence of the ossified pterygoalar ligament in Brazilian human skulls and analyzing its clinical importance. 183 Brazilian adult (between 30 to 60 years old) dry human skulls were evaluated. Was evaluated the incidence of skulls with complete or partial ossification of the pterygoalar ligament, bilaterally and unilaterally and in the presence on the right and left sides. Were found 5 skulls had the ossified pterygoalar ligament, resulting in an overall incidence of 2.73%. There was 1 skull in the presence of the incomplete ossification of the pterygoalar ligament, unilaterally and on the left side resulting in incidence of 0.54%. There were 4 skulls in the presence of the complete ossification of the pterygoalar ligament, unilaterally and on the right side resulting in incidence of 2.18%. The ossified pterygoalar ligament is a major cause of the entrapment of the lingual nerve or a branch of the mandibular nerve and may cause mandibular neuralgia. The incidence of the ossified pterygoalar ligament and the pterygoalar foramen is low in the Brazilian population. However, these structures have clinical significance as this ligament establish relationships with the ovale foramen and difficulty in accessing in this foramen in a therapeutic approach.