Background
The purpose of this study was to create dental radiation maps to calculate the mean dose to individual teeth, maxilla and mandible using intensity‐modulated radiation therapy (IMRT).
Methods
Eighteen common clinical settings were chosen. Radiation plans were extracted, and each tooth was contoured at its junction with the gingiva and labeled based on the Universal/American numbering system.
Results
All patients were treated with prescribed doses of 50–70 Gy in 1.66–2 Gy/fraction. Patients receiving mean doses >50 Gy to the teeth, mandible, and maxilla included those with advanced tumors of the oral cavity and gross lymphadenopathy of level 1b.
Conclusion
We believe this to be the first study generating dosimetric maps of estimated doses to each tooth and each third of the mandible and the maxilla for common examples of head and neck cancer faced by radiation oncologists. Adoption of these dental maps may help improve clinical workflow efficiency.
The adult basal ganglia arise from the medial and lateral ganglionic eminences, morphologically distinct structures found in the embryonic telencephalon. We have previously shown that temporal changes in sonic hedgehog (Shh) responsiveness determine the sequential induction of embryonic neurons that populate the medial and lateral ganglionic eminences. In this report, we show that Shh-mediated differentiation of neurons that populate the lateral ganglionic eminence express different combinations of the homeobox-containing transcription factors Dlx, Mash1 and Islet 1/2. Furthermore, we show that N-terminal fatty-acylation of Shh significantly enhances its ability to induce the differentiation of rat E11 telencephalic neurons expressing Dlx, Islet 1/2 or Mash1. Recent evidence indicates that in utero injection of the E9.5 mouse forebrain with retroviruses encoding wild-type Shh induces the ectopic expression of Dlx2 and severe deformities in the brain. In this report, we show that Shh containing a mutation at the site of acylation prevents either of these phenotypes. These results suggest that N-terminal fatty-acylation of Shh may play an important role in Shh-dependent signaling during rodent ventral forebrain formation.
Subepithelial gingival connective tissue grafts are a common surgical procedure performed in periodontal and implant surgery. This versatile procedure has many indications including tooth root coverage, thickening of gingiva, and improvement of the quality of the crestal gingiva. Several techniques have been described for graft harvest from the palate. Reported complications from these techniques include pain, inflammation, bleeding, flap necrosis, and infection in the donor site. We report a previously unpublished complication following subepithelial gingival connective tissue graft from the palate: pseudoaneurysm of the greater palatine vessel.
Mood stabilizers are often used in the treatment of psychosis and agitation associated with dementia. It has been shown that the antiepileptic drug topiramate (TPM) reduced brain tissue damage in a rat model of middle cerebral artery occlusion, suggesting that it may have a neuroprotective effect. We tested this possibility using confocal microscopy to measure cell death in organotypic hippocampal tissue cultures from 5-7-day-old Fischer 344 rats. To induce death, cultures were treated with N-methyl-daspartate (NMDA, 50 mM, 30 min), kainate (KA, 1-100 mm, 60 min), or transferred to a fresh culture medium. Cell death was measured as propidium iodide fluorescence 24 and 48 h after the insult and normalized to the maximal number of dead cells in the culture; maximal killing was achieved by exposing cultures to 41C ambient temperature for 48 h. Treatment of cultures with TPM at low concentrations (0.01-1 mm) for 48 but not for 24 h prior to the insult significantly increased survival. Concentrations above 1 mm were ineffective. TPM (0.1 mm) protected against kainate toxicity in the CA1 area, but not the CA3-4 area. TPM did not reduce cell death in the culture medium exchange model. TPM was ineffective in cultures treated with Na þ channel blocker tetrodotoxin. Pretreatment with both 0.1 mm TPM and 1 mm Ca 2þ / diacylglycerol-dependent PKC inhibitor Gö 6976 blocked the protective effect of topiramate against NMDA. These data suggest that protective action of TPM against NMDA toxicity may involve PKC activation and Na þ channel blockade and that at low doses TPM may be a clinically useful neuroprotective agent. Drug Dev.
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