D. Statelova

Successful treatment of extreme acute lead intoxication

Severe acute lead intoxications are rare and are associated with accidental or purposeful ingestion. There were only few cases of severe to fatal poisonings reported in literature in children. We report a case of acute lead intoxication in a child with extremely high lead blood level of 20.4 μmol/L (422.7 μg/dL), who was treated with chelation and in whom significant organ dysfunction did not develop. Documented significant high level above 3.37 μmol/L (corresponding to 70 μg/dL) in this patient persisted for approximately 24 h. Adequate, single or combined chelatation therapy in early phase of acute lead poisoning is essential for the further patient’s outcome.

Expression of antiapoptotic protein survivin in malignant melanoma

We examined the expression of potential tumor marker survivin by immunohistochemical staining using antisurvivin antibody (DAKO, Clone 12C4) in a panel of 25 malignant melanomas. In each section, we assessed the percentage of positively stained tumor cells, the intensity of staining and its subcellular localization. Survivin was present in 23 out of 25 cases (92%). Nuclear staining was found in 2 of these 23 cases (8.7%) only, while cytoplasmic staining only was seen in 3 of them (13%). The combined nuclear as well as cytoplasmic localization of survivin was demonstrated in 18 out of 23 cases (78.3%). In 2 cases revealing nuclear staining only, the worse histological features were more pronounced than in 3 cases with cytoplasmic staining only. Our results suggest that nuclear positivity of survivin may correlate with the degree of malignancy. In addition, we conclude that overexpression of survivin involved in the pathogenesis of melanoma represents an important diagnostic marker.

The embryonic nucleologenesis during inhibition of major transcriptional activity in bovine preimplantation embryos

Common features of embryonic genome activation in mammalian and non-mammalian embryos are the colocalization of pre-assembled complexes of maternally inherited nucleolar proteins, the so-called nucleolus precursor bodies and de novo synthesized transcripts with ribosomal DNA. The de novo transcription of messenger RNA and ribosomal RNA proteins is required for the development of functional nuclei during the major activation of the embryonic genome. The aim of our work was to investigate to what extent. Autoradiography and transmission electron microscopy has been applied in in vitro produced bovine embryos. The embryos were cultured to the late 8-cell stage with: α-amanitin; a specific inhibitor of RNA-polymerases II and III transcription; actinomycin D; a specific inhibitor of RNA polymerase I transcription; and without inhibitors (control group). Nucleoplasm and nucleolar structures displayed strong autoradiographic labeling and showed the initial development of fibrillo-granular nucleoli in the control group. In α-amanitin groups, however, in both inhibited groups of embryos, lack of autoradiographic labeling and disintegrated nucleolus precursor bodies stage were observed. Our study of α-amanitin as well as in actinomycin D groups proves inhibition of transformation nucleolus precursor bodies to active nucleoli. From our results follows, actinomycin D is able to penetrate through zona pellucida, what was shown for the first time.

The influence of orthodontic non-extraction treatment on the change in the inclination and position of incisors in the Europoid race

AIM To detect post-treatment change in the inclination and position of incisors in cases treated with orthodontic non- extraction therapy. MATERIALS AND METHODS The group consisted of 102 patients without extractions in lower and upper dental arch during orthodontic treatment. Cephalogram examination evaluated the position of the lower incisor to point A by Downs-pogonion line (-1 to APo) and inclination of the lower incisor to mandibular line (-1 to ML), position of the upper incisor to nasion-pogonion line (+1 to NPo), inclination of the upper incisor to nasion-sella line (+1 to NS) and the size of the inter-incisival angle between upper and central lower incisor (-1 to +1). RESULTS In 58 % of cases, the difference in post-treatment and pre-treatment changes in the position of the (-1 to Apo) was within ± 2 mm, which we considered stable. Statistically significantly higher values after treatment were in unstable rather than in stable cases with values (-1 to Apo), (-1 to ML), (+1 to NPo). Statistically significantly lower value after the treatment was measured in unstable cases rather than in stable cases with a value (-1 to +1). There was no statistically significantly different value in stable and unstable cases after treatment in values (+1 to NS). CONCLUSION The number of stable post-treatment cases was only 16 % higher than the number of unstable cases. With the increasing value (-1 to Apo), the value (-1 to ML) and (+1 to NPo) increased, the value (+1 to -1) decreased. The value (-1 to NS) not after treatment was not statistically significantly different in stable and unstable cases (Tab. 6, Fig. 4, Ref. 27).

Direct Oral Anticoagulant Drugs in Dental Clinical Practice

Abstract The direct oral anticoagulant drugs (DOAC) are generally safe and effective in several clinical settings including acute venous thromboembolic disease, prophylaxis in the postoperative setting, prevention of thromboembolism in patients with non-valvular atrial fibrillation, and in the management of acute coronary syndrome. The relatively short half-life, rapid onset of action, and predictable pharmacokinetics should simplify periprocedural use of the DOAC. The aim of this work is to propose and summarize periprocedural management of patients treated with the DOAC in dental practice and to inform about the principal specifications of this treatment.

Pseudomonas Infection of the Temporomandibular Joint (TMJ) Health and Public Health Issues

Abstract The authors describe a case of a rare infectious disease of intra-articular tissues of the temporomandibular joint caused mainly by Pseudomonas aeruginosa. In scientific literature, under the heading invasive (malignant) external otitis, we can find cases of an infectious disease of the external acoustic meatus caused by a microbial agent of Pseudomonas aeruginosa which can subsequently penetrate into structures. However, a primary affliction of the abovementioned structures has not been described. Localisation and severity of the infection requires long-term and massive treatment with antibiotics.

Emergence of Cranio-Cervico-Facial Soft Tissue Emphysema after Dental Hygiene Treatment Using Airflow (Case Report)

Abstract The authors report an interesting case of dangerous complications during dental hygienist treatment. Soft tissue emphysema during, and after stomatological procedures is described in several works. Such a complication after „airflowing“ has not yet been published in literature.

Epidemiological Analysis on 3614 Patients with Temporo-Mandibular Disorders (TMD) Basic Statistical Aspects

Abstract The aim of this work was to present data from a large sample of patients with Temporo-Mandibular Disorders (TMD) in order to clarify some aspects of the development of pathological conditions that affect large parts of the population. In the past years there was a rapid growth of the incidence of the temporomandibular dissorders. The ethiopathogenesis is in most cases unclear. Based on the latest information supposed are the biopsychosocial factors.

Unilateral Condylar Hyperplasia of the Mandible

Abstract Condylar hyperplasia (CH) of the mandible is a rare pathology that occurs at the head of the condyle and can lead to facial asymmetry affecting occlusion and possible association with pain and dysfunction. Unilateral condylar hyperplasia is an uncommon condition of unknown aetiology, proper diagnosis of which has to be established, as the patients may look for surgical help. A rare case of unilateral condylar hyperplasia of the mandible is reported here.

Bisphosphonate - Related Osteonecrosis of the Jaw – Five Years Experience

Abstract Background. Osteonecrosis related to bisphosphonate therapy is a challenging disease with complicated treatment. It is well known among the maxillofacial surgeons all around the world since 2003. Despite of it, the incidence is still rising, because of the lack of prevention before using bisphosphonates. Disturbing the bone metabolism leads by even a small trauma to enormous defects, that is despite of intensive therapy irreversible. Treatment of this disease is commonly joint with losing the bone tissue and badly affects the quality of life. Often is necessary the combined therapy, surgery, antibiotics and antimycotics. The discontinuation of bisphosphonate treatment during the osteonecrosis therapy is also recommended if it is possible. Methods and results. We examined and treated 79 patients with bisphosphonate related osteonecrosis of the jaw. The comparison of several methods of treatment was made in all stages of disease, with research of the therapy length, complications together with the need of reoperation and following up all the patients during five years. The results of the therapy were in most cases satisfactory; only two patients had problems that persisted. None of the patients died because of this disease. Conclusions. Bisphosphonate related osteonecrosis of the jaw is a disease that is difficult to treat. For patient it costs too much, not because of using the expensive antibiotics, but mostly because it leads to the defects in patient’s jaw, it is affecting the oral intake and the life of the patient at all. Prevention is the best way to discontinuation of the rising incidence, but it requires a cooperation of interested specialists and also perfect education of the patient.