The purpose of this study was to investigate the growth and differentiation potential of dental pulp cells (DPCs) in three-dimensional (3-D) collagen type-1 scaffold in vitro and in vivo. Third passage DPCs were cultured in a 3-D collagen and expression of both bone- or dentin-related mRNA (alkaline phosphatase (ALP), bone sialoprotein (BSP) and osteopontin (OPN)) and morphological changes evaluated in vitro. In the in vivo study, two types of grafts were transplanted into the rectus abdominus muscles of rats and harvested after 7 days: DPCs in α-minimal essential medium and DPCs mixed with a collagen gel. ALP, BSP and OPN were used as primary antibodies for immunohistochemical study. Histological and immunohistochemical results showed that DPCs in collagen gel were spindle shaped and showed significantly greater expression of ALP, BSP and OPN in vitro than the controls. Transplanted DPCs in collagen type-1 gel showed greater positive immunoreactivity for ALP, BSP and OPN than the controls. It was concluded that the collagen gel scaffold encouraged the differentiation of DPCs into osteoblastic cells.

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Objective:(1) The diagnostic accuracy of tympanometry in detecting fluid in the middle ear space in children with otitis media with effusion by comparing its findings with those of myringotomies. (2) Identify the age group most commonly affected by OME.Methods:This prospective study was conducted at the Department of ENT& Head and Neck Surgery, Postgraduate Medical Institute Hayatabad Medical complex, Peshawar from July 1, 2012 to April 30, 2015. Patients with suspicion of OME underwent tympanometry and later myringotomies. Using Jerger’s classification, Type B tympanogram with normal canal volume was considered as conclusive evidence of fluid in the middle ear space. Its findings were compared with those of the respective myringotomies. From the data collected, the accuracy, sensitivity, specificity, positive predictive value and negative predictive values were calculated.Results:A total 117 ears of 63 patients were operated. The age range was 3 to 12 years. The commonest age group (58.7%) affected by OME was 6-8 years. Type B tympanogram with flat curve and normal canal volume was obtained in 71.4% of the ears. Comparison with myringotomy findings showed TP 85, TN 13, FP 5 and FN 14. The diagnostic value of tympanometry was; Sensitivity 85.85%, Specificity 72.22%, PPV 94.44%, NPV 48.14% and Accuracy of 83.76%. P value calculated using chi square test showed that there was significant difference between tympanometry and myringotomy findings in OME (p < 0.05).Conclusions:OME is common in age group 6-8 years. Tympanogram Type B with normal canal volume is fairly sensitive in diagnosing this condition. However for occurrence of false positive results, final decision regarding management should be made on clinical findings and other supportive audiological tests.

Background: HER-2/neu is a member of the human epidermal growth factor (HER) family of transmembrane tyrosine kinases, which is significantly associated with the pathogenesis of various cancer types. The aim was to evaluate the expression of HER-2/neu in oral squamous cell carcinoma (OSCC) as a potential biomarker to target antigens for specific immunotherapy in OSCC. Methods: One hundred and forty histologically diagnosed OSCC cases were identified. Four to five-micrometer thick formalin-fixed, paraffin-embedded tumor sections were stained with Haematoxylin and Eosin (H and E). Histological grade was assessed according to WHO/Broders classification, while tumors were staged according to the American Joint Committee on Cancer (AJCC) TNM classification from stage I to IV. Immunohistochemistry was performed by using Rabbit monoclonal antibody against HER-2/neu (EP700Y, cell marquee and diluted 1:50). FISH was performed on positive cases using Vysis PathVysion HER-2 DNA probe (Abbott USA). Probes consist of LSI HER gene spectrum orange and control probe CEP 17 spectrum green. Results: In this study, males were mostly effected (64.3%) with buccal mucosa (49%) to be the commonly involved site for OSCC. Majority of cases were moderately differentiated (62.1%) and 50.7% tumors were Stage IV. HER-2/neu was found to be positive (2+) in one case of OSCC, however weak to moderate complete membrane staining was observed in >10% of the tumor cells. One hundred and thirty nine cases were HER-2/neu negative. FISH analysis of HER-2/neu positive cases also showed gene amplification (Her2-neu/ CEp 17 = 225/33 = 7.2). Conclusions: The study showed disparity in the expression of HER-2/neu in OSCC, which is due to multiple reasons. Therefore therapy against HER-2/neu in OSCC is debatable.

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The objective of this study was to determine the relations between the hallmark circulatory finding of decompensated cirrhosis, a reduced systemic vascular resistance (SVR), and the indices of hepatic decompensation, the accumulation of ascites, and the concentrations of various vasoactive substances. At a university-affiliated teaching hospital, eighteen hospitalized patients with cirrhosis and 18 age- and sex-matched healthy subjects were used. This was a case-control study. Measurements included cardiac dimensions and indices derived from echocardiograms and Doppler studies, abdominal ultrasound estimates of ascites, indices of hepatic function, and various serum (S) and urinary (U) substances. Results showed that cirrhotics had increased left atrial and left ventricular dimensions, left ventricular mass, heart rate, cardiac output (CO), transvalvular velocities, and a decreased SVR. SVR was related to hepatic dysfunction, as reflected by an abnormal prothrombin time ratio (r = -0.64, p = 0.006), and also related to overall severity of liver disease as estimated by the Child-Pugh score (r = -0.53, p = 0.044). Although cirrhotics with ascites generally had a reduced SVR, estimates of ascites were directly related to SVR (r = 0.57, p = 0.03) and inversely related to CO (r = -0.53, p = 0.04). Concentrations of S and U digoxin-like immunoreactive substance (DLIS) were also increased, but the concentrations of S glucagon and estradiol were not elevated. The accumulations of S and U DLIS, S glucagon, and S estradiol were all related to hepatic dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

We studied the value of angina pectoris as a predictor of significant coronary artery disease (CAD) in very elderly patients with severe aortic stenosis (AS). The study population consisted of patients with age at least 70 years who were referred for balloon aortic valvuloplasty (n = 90 patients). Routine coronary angiography was performed before the valvular intervention. Patients were grouped according to the presence or absence of angina pectoris. Of the patients with angina pectoris, 78% had obstructive (>50% diameter stenosis) CAD on coronary angiogram, while only 17% of patients without angina pectoris had obstructive CAD (p < 0.01). Angina pectoris had a sensitivity of 78% and a specificity of 82% for prediction of obstructive CAD. This suggests that in elderly patients with severe AS, the presence of angina pectoris is a strong determinant of CAD, and the absence of angina strongly suggests absence of obstructive CAD. In a very elderly population, appropriate decision-making with respect to AS management should not await diagnostic coronary angiography.

Objective: The purpose of this study was to investigate pulp responses after CO 2 laser irradiation of rat molars using reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemical methods. Background data: Many kinds of lasers have been used for the treatment of dentin hypersensitivity. However, the immunohistochemical details of the responses of dentin-pulp complex cells after CO 2 laser irradiation through the dentin are still not clear. Methods: Adult male Sprague-Dawley rats were used in this study. A CO 2 laser (wavelength of 10.6 lm, 2 W in the super pulse mode, pulse 0.6 ms) and total laser energy of 4 J (density, 203.84 J/cm 2 ) was used. The temperature change in the pulp was measured using a super fine sheath thermocouple. Results: The temperature at the pulp side after the CO 2 laser irradiation increased 22.5°C. The expression of tumor necrosis factor-alpha (TNF-a) and interleukin (IL)-1-a mRNAs was significantly higher at 6, 12, and 24 h after laser irradiation than in the control group ( p < 0.05). Histologically, a slight degeneration of the pulp tissue was observed immediately after the laser irradiation. Immunohistochemically, heat shock protein (HSP)-70-positive cells in the pulp horn were observed immediately after irradiation and cells positive for vascular endothelial growth factor (VEGF) in the subodontoblast layer were observed after 5 days. There were no nestinpositive cells immediately, but after 5 days nestin-positive cells were recognized in the deeper pulp cells. Immediately after irradiation, neurofilament protein (NFP)-positive nerve fibers were observed but they disappeared in the pulp horn after 5 days. Conclusions: These results suggest that 203.84 J/cm 2 CO 2 laser irradiation of pulp tissue through the dentin, such as is used in the clinic, induces inflammatory and pathological cytokine pathways to repair the damaged pulp tissue.