Cone-beam computed tomography analysis of curved root canals after mechanical preparation with three nickel-titanium rotary instruments

Cone beam computed tomography is a 3-dimensional high resolution imaging method. The purpose of this study was to compare the effects of 3 different NiTi rotary instruments used to prepare curved root canals on the final shape of the curved canals and total amount of root canal transportation by using cone-beam computed tomography. A total of 81 mesial root canals from 42 extracted human mandibular molars, with a curvature ranging from 15 to 45 degrees, were selected. Canals were randomly divided into 3 groups of 27 each. After preparation with Protaper, Revo-S and Hero Shaper, the amount of transportation and centering ability that occurred were assessed by using cone beam computed tomography. Utilizing preand post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. Canals were metrically assessed for changes （surface area, changes in curvature and transportation） during canal preparation by using software SimPlant; instrument failures were also recorded. Mean total widths and outer and inner width measurements were determined on each central canal path and differences were statistically analyzed. The results showed that all instruments maintained the original canal curvature well with no significant differences between the different files （P=0.226）. During preparation there was failure of only one file （the protaper group）. In conclusion, under the conditions of this study, all instruments maintained the original canal curvature well and were safe to use. Areas of uninstrumented root canal wall were left in all regions using the various systems.

Prognostic and Clinicopathological Value of the Expression of FOXC2 &YKL-40 in Carcinoma of the Breast, an Immunohistochemical Study

Background: Breast cancer is considered the commonest and the most fatal female cancer worldwide. There is to an urgent need for discovering recent therapies to identify patient prognosis and improve treatment strategies. Fork-head Box C2 (FOXC2) is a transcription factor which is a key regulator of cancer stem cells (CSC) properties and epithelial mesenchymal transition (EMT) e.g. cancer initiation, metastatic capacity, and resistance to chemotherapy. FOXC2 roles in CSCs properties and EMT regulation in breast cancer needs detailed studies. YKL-40 is known as chitinase-3-like-1 belongs to a family of mammalian proteins that have an amino acid sequence which is similar to the 18-glycosyl hydrolase bacterial chitinases group. Recent studies have found aberrant YKL-40 elevated expression in cancer of various organs, so it may be used as a recent prognostic biomarker for patients with breast cancer. Former researchers have assessed the expression of FOXC2 & YKL-40 separately in cancer patients and relations to prognosis of patients;however, no studies assessed them together in breast cancer patients and the previous results were inconclusive. Accordingly, our study aimed at evaluation of immunohistochemical expressions of FOXC2 & YKL-40 in carcinoma of the breast in a trial to clarify the relation among their expressions, clinicopathological parameters and recurrence of the disease after successive therapy and patients’ prognosis. Methods: we have evaluated expressions of FOXC2 & YKL-40 in sections from 50 paraffin blocks of carcinoma of the breast using immunohistochemistry. We followed up our patients for 3 years for assessment of recurrence of the disease after successive therapy and survival rates. We analyzed the relationship between their combined expression clinicopathological and prognostic parameters. Results: high FOXC2 expression was associated with older age of the patient (p = 0.002), negative ER (p = 0.009), & PR (p = 0.008), positive HER2neu (p = 0.02), aggressive molecular subtype, higher grade of the tumor (p = 0.03), high incidence of distant metastasis (p = 0.011), high incidence of lymph node metastasis, higher KI labeling index, advanced stage, (p < 0.001). high YKL-40 expression was positively correlated with older age of the patient (p = 0.002), negative ER (p = 0.03), & PR (p = 0.04), positive HER2neu (p = 0.02), higher grade of the tumor (p = 0.003), high incidence of distant metastasis (p = 0.04), higher KI labeling index, aggressive molecular subtype, advanced stage, high incidence of lymph node metastasis (p < 0.001). We have found that patients with FOXC2 and YKL-40 overexpression have higher incidence of recurrence of the disease after therapy, poor RFS& OS rates (p Conclusion: Higher expression levels of FOXC2 & YKL-40 are markers of poor prognosis in breast cancer.

Susceptibility-Weighted MRI in the Evaluation of Gynecologic Diseases

Introduction: Owing to the advanced development of MRI science, it causes obvious great changes of many diseases that affect the female genital system and affect their fertility. Hemorrhagic gynecological diseases especially endometriosis affect young females and cause cyclic pain, in addition to infertility. So early detection is essential for proper treatment. Susceptibility-weighted (SWI) as one of the most recent newly created MRI sequences is highly sensitive to detect products of hemorrhage within different gynecologic disorders with 94.7% sensitivity being more meticulous than conventional MRI sequences as T1 and T2. Aim of the Work: A comparison between T1 and T2 as conventional MRI sequences with susceptibility-weighted images (SWI) in many gynecologic disorders by the detection of the presence of internal products of hemorrhage at any stage. Subjects and Methods: 48 consecutive patients from Benha University clinics (age range, 17 - 60 years;mean age, 35.67 years). The patients included in the study were presenting with pelvic pain, irregular menses, Dyspareunia, and swelling. All with suspicious diagnosis of ovarian and extra-ovarian lesions. 38 patients out of the 48 patients were known to contain hemorrhagic disorder;all the patients underwent MRI routine pelvis protocol adding SWI sequence. Results: There was a greatly significant difference between SWI and conventional MRI sequences T1and T2 with sensitivity 94.7%, 57.9% and 33.3% respectively. Conclusion: SWI is a promising tool in the evaluation of hemorrhagic foci within different gynecological disorders. The great ability of detecting hemosiderin foci increases the value of SWI over conventional MRI or US.