Excessive Enlargement Research Articles

A study of macrodontia of the permanent maxillary central incisors among Delta State University students in Abraka, Nigeria

Macrodontia (or megadontia) is a rare dental anomaly characterized by excessive enlargement of all tooth structures, and in few cases may be associated with morphological anomalies. The goal of this study was to find out how common macrodontia of the maxillary central incisors was among Delta State University students in Abraka. The Research and Ethical Committee of the Department of Human Anatomy and Cell Biology, Delta State University, Abraka, gave approval for this study. A descriptive cross-sectional survey with a representative sample of 102 subjects was conducted (58 female and 44 male). The method used was a simple random sampling technique. The age and sex of each subject were obtained using a data form, and intra-oral measurements of the mesio-distal width of the maxillary right central incisors were taken. Results were arranged according to age and sex to ascertain the occurrence of sexual dimorphism; independent sample t test and chi-square test were used as inferential statistical tools. The prevalence of macrodontia was 35.3%; there was a significant sex difference, as p value was <0.05; there was no significant difference within the age groups, as p-value was > 0.05. The mean mesio-distal width was 8.54±0.25 mm in those who did not have macrodontia and 9.63±0.54 mm in those who did have macrodontia. Macrodontia of central incisors is dominant amid Delta State University learners in Abraka.

Gestational Gigantomastia: Case Report and Review of Treatment Options.

Gestational gigantomastia is a rare and devastating condition involving rapid and excessive enlargement of the breast tissue during pregnancy or postpartum. We review the workup, assessment, and care of a patient with gestational gigantomastia with superimposed mastitis. Conservative treatment, medical management, and surgical options should be explored with patients. It is also important for providers to be cognizant of the psychological impact of this condition.

Diet Change Improves Obesity and Lipid Deposition in High-Fat Diet-Induced Mice

The number of obese people is increasing dramatically worldwide, and one of the major causes of obesity is excess energy due to high-fat diets. Several studies have shown that reducing food and energy intake represents a key intervention or treatment to combat overweight/obesity. Here, we conducted a 12-week energy-restricted dietary intervention for high-fat diet-induced obese mice (C57BL/6J) to investigate the effectiveness of diet change in improving obesity. The results revealed that the diet change from HFD to NFD significantly reduced weight gain and subcutaneous adipose tissue weight in high-fat diet-induced obese mice, providing scientific evidence for the effectiveness of diet change in improving body weight and fat deposition in obese individuals. Regarding the potential explanations for these observations, weight reduction may be attributed to the excessive enlargement of adipocytes in the white adipose tissue of obese mice that were inhibited. Diet change significantly promoted lipolysis in the adipose tissue (eWAT: Adrb3, Plin1, HSL, and CPTA1a; ingWAT: CPT1a) and liver (reduced content of nonesterified fatty acids), and reduced lipogenesis in ingWAT (Dgat2). Moreover, the proportion of proliferative stem cells in vWAT and sWAT changed dramatically with diet change. Overall, our study reveals the phenotypic, structural, and metabolic diversity of multiple tissues (vWAT and sWAT) in response to diet change and identifies a role for adipocyte stem cells in the tissue specificity of diet change.

Tracheomegaly as a Potential Predictor of Severe Tracheal Damage in COVID-19 Patients on Long-Term Mechanical Ventilation

Tracheomegaly (TM) is a rare appearance that is radiologically defined as an excessive enlargement of the tracheal diameter. We present a comprehensive analysis of tracheal diameter measurements and TM incidence in patients admitted and treated due to COVID-19 pneumonitis and its association with possible respiratory complications. In this retrospective study, we included 1015 patients divided into three groups: 383 patients treated using mechanical ventilation (MV), 132 patients treated using high-flow ventilation (HFV), and 500 randomly selected patients using nasal catheter (NC) oxygenation. The tracheal lumen diameter was measured continuously using a chest X-ray, and the cuff/trachea (C/T) diameter ratio was calculated. We detected TM in 71 patients (18.54%). Regression analysis showed statistical significance in MV patients for the trachea diameter at the level of the cuff, maximal trachea diameter and C/T diameter ratio, and days on MV. Respiratory complications showed a significant association with the C/T diameter ratio. The C/T diameter ratio was shown to be a reliable potential predictor of the occurrence of respiratory complications. The results of the study highlight the importance of the early detection and prevention of TM in COVID-19 patients on MV using a chest X-ray and measurement of the C/T diameter ratio.

Subdural Hygroma- A Case Report

Introduction: An accumulation of Cerebrospinal fluid in subdural spaces is known as subdural hygroma. It is encountered in all age-groups but overall, most common in elderly. The exact pathogenesis of Subdural Hygroma is still unclear.
 Presentation of Case: A 03 months old female child was brought to Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India on date 02/10/2020 with the complaints of breathing difficulty, elevated body temperature, excessive enlargement of head with bulged and tense fontanel, high pitch shrill cry, restlessness, nausea and vomiting. On physical examination, it is found that head circumference was 44 cm, head size was enlarged, bulged anterior fontanel, angular cheilitis, pale conjunctiva as well as peripheral cyanosis were present. The child was diagnosed at birth and child was brought to Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha for surgical management of subdural hygroma.
 Intervention: The treatment of patients was started immediately after admission.Burr-Hole Evacuation was done on 4th October 2020 and the patient was discharged on 08th October 2020. 
 Conclusion: In this report, we mainly focus on expert surgical management and excellent nursing care helped in managing the complicated case very nicely. The patient response was positive to conservative and nursing management. The patient was discharged without postoperative complications and satisfactory with recovery.

Alendronate inhibits triglyceride accumulation and oxidative stress in adipocytes and the inflammatory response of macrophages which are associated with adipose tissue dysfunction.

Alendronate, a bisphosphonate used to prevent osteoporosis, stimulates osteogenesis but impairs adipogenesis. Different clinical trials suggest that the incidence of diabetes may be lower in patients treated with alendronate. Taking into account the importance of adipocytes and macrophages of adipose tissue in insulin resistance and type 2 diabetes, it is necessary to evaluate the effect of alendronate in both cell types. In this paper, we investigated the effect of alendronate on the differentiation to adipocytes of 3T3-L1 fibroblasts, the cell line most used to study adipogenesis, and also its effect on lipid content and oxidative stress in mature adipocytes as well as on the inflammatory response of macrophages. We found that alendronate inhibits differentiation of 3T3-L1 fibroblasts to adipocytes in keeping with reports in other cell lines. On the other hand, treatment of 3T3-L1 adipocytes with alendronate was able to decrease triglyceride content and to prevent H2O2-induced lipid peroxidation which was evaluated as an indicator of oxidative stress. In addition, it was found that activation of RAW 264.7 macrophages to a pro-inflammatory M1 type is inhibited by this bisphosphonate. These results suggest that alendronate may contribute to prevent adipocyte excessive enlargement and the induction of oxidative stress in 3T3-L1 adipocytes as well as the activation of macrophages to a pro-inflammatory M1 type, which are events associated with adipose tissue dysfunction and insulin resistance. In this study, we unraveled the underlying mechanisms of events that were previously observed in clinical trials.

T. Boryssowicz. Stale rozszerzenie ujscia zewnetrirnego macicy, zapomoca przewiazania bocznych scian dolnego odcinka czesc pochwowej (Medycyna, 1893, no. 9). Persistent expansion of the external uterine opening by ligation of the lateral walls of the lower branch of the vaginal part (Dilatatio ostii externi uteri ope ligaturae)

Persistent expansion of the canal of the uterine cervix in order to cure infertility or painful months began to be applied even from the beginning of the past century. But all the methods of discisionis portionis vaginalis proposed so far leave a lot to be desired and, according to Schroeder, produce either too little or excessive enlargement of the external opening, always disfiguring the vaginal part.

A new method for urine electrofiltration and long term power enhancement using surface modified anodes with activated carbon in ceramic microbial fuel cells

This work is presenting for the first time the use of inexpensive and efficient anode material for boosting power production, as well as improving electrofiltration of human urine in tubular microbial fuel cells (MFCs). The MFCs were constructed using unglazed ceramic clay functioning as the membrane and chassis. The study is looking into effective anodic surface modification by applying activated carbon micro-nanostructure onto carbon fibres that allows electrode packing without excessive enlargement of the electrode. The surface treatment of the carbon veil matrix resulted in 3.7 mW (52.9 W m−3 and 1626 mW m−2) of power generated and almost a 10-fold increase in the anodic current due to the doping as well as long-term stability in one year of continuous operation. The higher power output resulted in the synthesis of clear catholyte, thereby i) avoiding cathode fouling and contributing to the active splitting of both pH and ions and ii) transforming urine into a purified catholyte - 30% salt reduction - by electroosmotic drag, whilst generating - rather than consuming – electricity, and in a way demonstrating electrofiltration. For the purpose of future technology implementation , the importance of simultaneous increase in power generation, long-term stability over 1 year and efficient urine cleaning by using low-cost materials, is very promising and helps the technology enter the wider market.

Diagnosing added value of convection-permitting regional models using precipitation event identification and tracking

Dynamical downscaling with high-resolution regional climate models may offer the possibility of realistically reproducing precipitation and weather events in climate simulations. As resolutions fall to order kilometers, the use of explicit rather than parametrized convection may offer even greater fidelity. However, these increased model resolutions both allow and require increasingly complex diagnostics for evaluating model fidelity. In this study we use a suite of dynamically downscaled simulations of the summertime U.S. (WRF driven by NCEP) with systematic variations in parameters and treatment of convection as a test case for evaluation of model precipitation. In particular, we use a novel rainstorm identification and tracking algorithm that allocates essentially all rainfall to individual precipitation events (Chang et al. 2016). This approach allows multiple insights, including that, at least in these runs, model wet bias is driven by excessive areal extent of precipitating events. Biases are time-dependent, producing excessive diurnal cycle amplitude. We show that this effect is produced not by new production of events but by excessive enlargement of long-lived precipitation events during daytime, and that in the domain average, precipitation biases appear best represented as additive offsets. Of all model configurations evaluated, convection-permitting simulations most consistently reduced biases in precipitation event characteristics.

Gestational Gigantomastia: Challenges in Management and Follow Up

Gestational Gigantomastia (GG) is a rare condition that presents with excessive enlargement of breast which becomes uncomfortable and embarrassing. Here is a case report of a primigravida who presented to us with GG at term. Post- elivery she had abscess formation and difficulties in breastfeeding. She was conservatively treated by abscess drainage and lactation suppression.

Planowanie przestrzenne jako czynnik kształtujący atrakcyjność rynkową nieruchomości – skuteczny i niebezpieczny

<p style="text-indent: 0cm;"> <span style="font-family: arial,helvetica,sans-serif; font-size: medium;">Pomiędzy planowaniem przestrzennym a rynkową atrakcyjnością nieruchomości występuje silny związek. Planowanie jest jednym z czynników kształtujących wartość nieruchomości. Dlatego też interesy uczestników rynku nieruchomości rzutują na decyzje planistyczne. W efekcie plany miejscowe wyznaczają przede wszystkim funkcje terenów zgodne z oczekiwaniami właścicieli nieruchomości, dające szanse na osiągnięcie wysokiej renty gruntowej. Mechanizm ten tworzy liczne pozytywne skutki dla całej lokalnej przestrzeni społeczno-ekonomicznej. Jego beneficjentami są nie tylko właściciele nieruchomości, ale także samorządy gminne i w pewnym stopniu całe otoczenie. Dostosowywanie ustaleń planów miejscowych może być jednym z czynników uruchamiających trwałe mechanizmy rozwoju lojalnego. Jednocześnie jednak prowadzi ono do wielokrotnie przesadzonego, wobec realnego popytu, powiększania powierzchni terenów mieszkaniowych. Skutkiem tego jest postępujące rozproszenie zabudowy. Obok skażenia krajobrazu powoduje ono także nadmierne koszty budowy i utrzymania infrastruktury technicznej i drogowej. Oznaczać to może trwałe ograniczenie możliwości finansowania przez gminę niezbędnych inwestycji rozwojowych. Nadmierna powierzchnia terenów budowlanych tworzy również ryzyko kreowania baniek spekulacyjnych. Dalsze wykorzystywanie pozytywnych skutków powiązań pomiędzy planowanie przestrzennym i gospodarką nieruchomościami, a jednocześnie eliminowanie skutków negatywnych, wymaga zapewne zmiany systemu planowania w Polsce. Jednakże nawet w ramach obecnego systemu możliwe jest osiągnięcie pozytywnych efektów przy odpowiednim poziomie wiedzy i skuteczności działań ze strony samorządu gminnego.</span></p>

The dentin thickness remaining in the risk zone of mandibular molars after cervical preflaring with four methods

Abstract Introduction Cervical preflaring is an important step of the canal system instrumentation, but can lead to excessive enlargement or root perforation. Objective Evaluate the remaining dentin thickness in the mandibular molars of mesial roots using cone beam computed tomography: Gates-Glidden (crown-down); Gates-Glidden (step-back); LA Axxess and Easy Pro-Design. Material and method Were selected 40 lower molars mesial roots, which were scanned in a cone beam CT scanner before and after preparation. Were obtained five sections of the CT images with an interval of 1 mm from the furcation, and measured the thickness variation between the root canal to the root external portion in analysis software. Result The evaluation of the different levels showed no significance within the same group for the Gates-Glidden group. On the other hand, were observed difference for LA Axxess (p=0.002) and Easy Pro-Design (p=0.005). In the intergroup analysis, were observed difference in all levels, especially for Gates-Glidden in the ascendant order (ANOVA and Tukey). Conclusion Within the limitations of these study, is possible to conclude that the protocol with greater wear in the cervical risk area was the Gates-Glidden in step-back sequence, as the other groups were equivalent (p>0.05).

The EU Succession Regulation and third country courts

The European Union Succession Regulation (Regulation (EU) No. 650/2012) (hereafter Succession Regulation) provides a comprehensive treatment of the diverse private international law issues concerning succession, encompassing within the same instrument rules on jurisdiction, applicable law and the recognition and enforcement of decisions and authentic instruments in succession matters. At the same time, each of these sets of rules coexisting within the Regulation bears its own regime in terms of spatial applicability. As concerns the rules on jurisdiction, these tend to regulate comprehensively all succession disputes, including those more closely connected to a third country, by providing for subsidiary jurisdiction rules and for a rule on forum necessitatis. Still, the rules contained in the Regulation as concerns choice of forum, as well as lis alibi pendens and related actions, are conceived from a purely inter partes perspective. This causes on the one hand the impossibility of re-establishing Gleichlauf where the deceased made a professio iuris in favour of the law of a third country, and, on the other hand, does not ensure a satisfactory coordination with parallel proceedings pending before third country courts. The subsidiary jurisdiction rules may in turn cause an excessive enlargement of the scope of the jurisdiction of Member States’ courts, and could also hinder the unity of the succession. The latter concern is likely to arise also in respect of the mechanism embodied in Article 12(1) of the Regulation, which achieves a rather incomplete coordination with the jurisdiction exercised by third country courts. Some suggestions will be submitted for amendments to be made to the Succession Regulation in order to overcome these shortcomings.

Pan-pneumatocele of Paranasal Sinuses: A Rare Entity

Excessive enlargement of the paranasal sinuses is a rare entity with an uncertain etiology. It usually affects the frontal sinus, although any sinus can be pathologically enlarged. Authors describe a case with enlargement of all paranasal sinuses (pan-pneumatocele). To date, this is the first reported case of pan-pneumatocele of paranasal sinuses in the literature.

Gestational Gigantomastia: A Rarity

ABSTRACT Hypertrophy of the breast is a rare medical condition of breast connective tissue. It is listed as a ‘rare disease’ by the ‘Office of Rare Diseases’ of National Institute of Health (NIH). A woman aged 20 years presented to our antenatal clinic in her first pregnancy at 23 weeks of gestation with excessive enlargement of breasts since conception. Although its etiology has yet to be clarified, it has been associated with the response of breast receptors to gestational hormones. Gestational gigantomastia is a complication whose etiology and pathogenesis have yet to be fully clarified. However it has been speculated that placental hormones may trigger the condition. How to cite this article Shakya D, Gupta T, Agrawal L, Premi HK. Gestational Gigantomastia: A Rarity. Int J Adv Integ Med Sci 2016;1(1):13-14.

PENATALAKSANAAN HIPERPLASIA GINGIVA DISEBABKAN OLEH PENGGUNAAN AMLODIPINE : Sebuah Laporan Kasus

Introduction : gingival hyperplasia is a result of administration from some anticonvulsant drugs, immunosuppressants, and calcium channel blockers that well known can cause problems when speaking, mastication, tooth eruption, and aesthetic. Calcium channel blockers are a class of drugs developed for the care of cardiovascular conditions. Some of these drugs can cause gingival enlargement. Case : A 55-year-old female patient came to Periodontal Department of Hasanuddin University Dental Hospital,Makassar. Patients present with a less comfortable and did not feel confident with the condition of the front of the upper jaw gums since three months ago. These symptoms begin to be felt since taking drugs for hypertension disease with amlodipine with 10 mg 1 time a day. The patient began to feel a change in the form of excessive enlargement of the gums almost the entire upper jaw teeth. Management of Case : Disinfection area of operation, anesthesia with lidocaine 2% of nor epinephrine, marking the pocket using the pocket marker basis, incision using Krickland knife, removal of gingiva using papilla Orban knife and performed by scaling and root planing, periodontal pack was used. Conclusion : Patients who took the drug amlodipine as calcium channel blocker classification in the long-term directly effects the growth of excess gingival tissue, causing gingival enlargement. Keyword: Hyperplasia Gingiva, Amlodipine

11 Arrhythmogenic Right Ventricular Cardiomyopathy-Like Phenotype Induced by Endurance Training and Prevented by Preload Reduction in Heterozygeous Desmoglein-2 Mutants

Arrhythmogenic right ventricular cardiomyopathy (ARVC) significantly contributes to sudden cardiac death in young otherwise healthy patients, especially endurance athletes. 5–10% of patients with ARVC harbour mutations in the extracellular domains of the desmoglein (DSG) 2 gene. To assess the role of DSG2 in ARVC pathomechanism, mice lacking exons 4–6 of the endogenous DSG2 gene (DSG2mt) were generated. Homozygous DSG2mt/mice developed dilatation of ventricles and pronounced fibrosis. Heterozygous DSG2mt/wt mutants did not show such morphological alterations. Methods To study whether exercise provokes a cardiac phenotype in DGSwt/mt mice, they were subjected to endurance training and compared with wild-type (WT) littermates. We also studied if preload reduction can prevent right ventricular dilation with training by concomitant therapy with nitrates and diuretics. Echocardiography was performed with 2% isoflurane + oxygen, using a small animal ultrasound unit. Right ventricular (RV) dimensions were increased in DSG2wt/mt after training compared to pre-training and compared to WT after training. Electrophysiological studies in isolated Langendorff DSGwt/mt and WT hearts from mice terminally anaesthetised with urethane (2 mg/kg) showed a correlation of the DSG2 mutation with increased arrhythmia inducibility after endurance training. Ventricular arrhythmias were induced by a single extra stimulus during right ventricular stimulation in 5 of 8 DSG2wt/mt, but in none of the 7 WT hearts (p = 0.03). Preload reduction prevented excessive right ventricular enlargement with endurance training in DSG2wt/mt. In conclusion, endurance training revealed an ARVC-like phenotype in heterozygous desmoglein mutant mice. Right ventricular dilation could be prevented by preload-reducing therapy.

Influence of registration based on different reference markers on the displacement of the geometry consisted of all clips in the cavity for external-beam partial breast irradiation at moderate deep inspiration breath holding

To investigate the influence of registration based on different reference markers on the displacement of the geometry consisted of all clips in the cavity for external-beam partial breast irradiation at moderate deep inspiration breath holding assisted by active breathing control device. Twenty-seven early stage breast cancer patients feasible for external beam partial breast irradiation (EB-PBI) were selected. The patients undertaken three-dimensional computed tomography (3DCT) simulation scan at moderate deep inspiration breath holding (mDIBH) assisted by active breathing control device, and two sets of mDIBH CT images were got and transferred to the Pinnacle 3 planning system. All of the silver clips were delineated and a geometry consisted of all clips were generated. On the account of automatic registration of mDIBH CT images, manual registration was carried out based separately on the topside clip in the cavity, the labeled skin at anterior surface of the cavity at central level and the metal mark on the body surface near the cavity, then the displacements of center of the geometry in left-right (LR), anterior-posterior (AP) and superior-inferior (SI) directions based separately on the three registrations were measured. The displacements of center of the geometry in LR, AP and SI directions based on registration of the clips, the labeled skin and the metal mark were (0.61 ± 0.62)mm vs. (1.11 ± 1.21)mm vs. (1.31 ± 1.55)mm, (0.63 ± 0.59)mm vs. (0.92 ± 0.93)mm vs. (1.19 ± 1.24)mm and (0.91 ± 0.96)mm vs. (2.13 ± 2.12)mm vs. (1.93 ± 1.55)mm, respectively. Compared the displacements of center of the geometry in the same direction between the three registrations, significant differences were found only in SI direction between clip registration and skin registration, clip registration and mark registration (t = 5.045, 7.210 and P = 0.025, 0.007) . Compared the displacements of center of the geometry between three dimensional directions for each reference registration, there was no significant difference (all P > 0.05). When EB-PBI is carried out in state of mDIBH, measurement of the intrafraction displacement based on registration of the clip in the cavity is a reasonable selection. Otherwise, excessive margin enlargement of PTV in SI direction will be generated if the regional skin or metal mark is selected as registration reference.

Juvenile Granulosa Cell Tumor and High Blood Ca-125 Levels in Children with Pseudo-Meigs Syndrome

Ovarian tumors and cysts are rarely seen in children. They constitute 1-2% of solid tumors among children. Over tumors are categorized into three main groups: epithelial, embrionic, and sex cord-stromal tumors. Sex cord-stromal tumors arise from primordial cell cords that are located in the center of the ovary during embriological development. We have detected a patient who was diagnosed with a juvenile granulosa cell tumor (JGCT) at two years of age after presenting with excessive breast enlargement during the past month. She had a large mass in the abdomen, ascites, and marked pleural effusion in the right hemithorax. This association was Pseudo-Meigs syndrome. The association of JGCT and Pseudo-Meigs syndrome is a considerably rare event. Moreover, since the patient was the youngest among all previously reported cases in existing literature, our observations indicate that a juvenile granulosa cell tumor may occur at an early age.In conclusion, Pseudo-Meigs syndrome with JGCT shouldn't forget, even in young children.

The role of mechanical instrumentation in the cleaning of root canals

The cleaning and shaping of the root canal is a key procedure in root canal treatment. The aim of cleaning is the removal of tissue remnants and bacterial biofilms in order to allow close adaptation of the root filling to the canal walls. In simple straight canals with a round cross‐section, this aim is easily attained by mechanical instrumentation and irrigation. The task of cleaning presents a greater challenge in oval canals, curved canals, and in canal systems that contain an isthmus. In areas that are inaccessible to mechanical instrumentation, the cleaning greatly depends on the action of sodium hypochlorite, which is used to dissolve and remove all of the remaining tissues and bacterial biofilms. Traditional irrigation with syringe and needle is often ineffective in cleaning such inaccessible areas. Newer irrigation methods allow for better cleaning by facilitating a more effective flow of irrigants; nevertheless, adequate, larger, mechanical preparations are required for the effective use of these methods. An alternative approach is to use a hollow file that adapts itself to the cross‐section of the canal, without excessive enlargement of the canal, thus allowing mechanical scrubbing of the walls with a continuous flow of the irrigant through the file. All cleaning methods reach their limit in cases of long narrow isthmuses that are often inaccessible to mechanical instrumentation; adequate instrumentation is, however, a prerequisite for all cleaning methods.