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Poster Session : PS 0316 ; Hematology : A Case of Pancytopenia
( Filipe Filipe ),( Joana Martins ),( Catarina Espirito Santo ),( Ligia Peixoto ),( Ines Vendrell ),( Helena Luna Pais ),( Alba Acabado ),( Paulo Cantiga Duarte ),( Jose Braz Nogueira ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Megaloblastosis represents a wide group of disorders sharing a common pathophysiological pathway, due to defi cient intake or absorption of Vitamin B12 and folic acid. Major causes for this condition include alcoholism, achlorhydria, pernicious anemia or gastrectomy and celiac disease. It leads to abnormal DNA replication, impaired protein synthesis and nuclear maturation. It presents with macrocytosis, hypersegmented neutrophils, and elevated Lactate dehydrogenase (LDH) levels. It is more prevalent in underdeveloped countries and older populations, having similar gender distribution. Authors present the case of a 69-year-old man, with a previous known history of essential thrombocytosis, medicated with hydroxyurea (with irregular adherence to treatment), congestive heart failure and chronic alcoholism. He was admitted at the emergency room (ER) with symptoms of confusion, slurred speech and fatigue for a week. He presented mucosal palor, fever (38. 1ºC), splenomegaly, and a left lateral maleolar ulcer with a purulent exsudate. Blood values revealed pancytopenia (macrocytic anemia Hb 4. 1 g/dL and MCV 123 fi); Leukocytes 1110x106/L; Platelet count 30. 000x106/L), acute renal failure (blood urea nitrogen 97 mg/dL; creatinine 2. 5 mg/ dL) LDH 1545 U/L. He underwent blood transfusions at the ER, without previous iron tests screening. On subsequent evaluation, authors found levels of Vitamin B12 of 172 pg/mL and folate 0. 9 nmol/L. Patient underwent a bone marrow aspiration with bone biopsy, compatible with megaloblastic anemia. An endoscopy was performed, with histological fi ndings suggestive of atrophic gastritis, with no H. pylori bacilli found. Additional tests such as anti-gastric parietal cells antibodies and anti-intrinsic factor antibodies, were negative. The patient was medicated with Vitamin B12 injections and folic acid, with good reticulocitary response. At discharge he presented, blood values of Hb 8. 7 g/dL; Leukocytes 7110x106/L; and platelet count of 862. 000x106/L. This represents a case of severe pancytopenia, enhancing the relevance of megaloblastosis as differential diagnosis for this entity.
Poster Session:PS 0184 ; Endocrinology : Multiple Endocrine Neoplasia Type 2B - A Late Presentation
( Ines Vendrell ),( Filipe Filipe ),( Helena Luna Pais ),( Joana Martins ),( Catarina Espirito Sabto ),( Antonio Pedro Machado ),( Paulo Cantiga Duarte ),( Jose Braz Nogueira ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Multiple Endocrine Neoplasia (MEN) is a rare condition which occurs 1-2/100.000 people and results from rearranged during transfection (RET) protooncogene mutations. MEN B is a particularly infrequent subtype of MEN (5% of all MENs) that usually presents during childhood with pseudo-hirschprung`s disease and skeletal abnormalities (marfanoid habitus). Medullary thyroid carcinoma occurs in almost all individuals and phaeochromocitoma can also be present. MEN 2B is an autosomal dominant disease. Yet, less than 50% of the patients have a family history (de novo mutations), as many perish before reproductive age. The authors describe the case of a 33-year-old male who presented with hypertension, tachycardia and high blood sugar levels. He had a history of cryptorchidism and bowel obstruction both surgically corrected during childhood. Moreover at the age of 30 he was diagnosed with ruptured diverticulitis and underwent a total colectomy (specimen showed reactive lymphoid hyperplasia and multiple diverticula). This patient had the classic marfanoid habitus and mucosal neuromas (lips and tongue), which prompted urine cathecolamine and metanephrine dosing. Abdominal CT scan showed bilateral adrenal masses (25mm and 77mm diameter) compatible with phaeochromocytoma. Given the phenotype, serum calcitonin dosing (over 2000 pg/mL), thyroid ultrasound (multiple nodules) and biopsy were performed, confi rming medullary thyroid carcinoma. Genetic testing reveled a germline point mutation in RET (p.M918T) known to be associated with MEN 2B. The patient later underwent total thyroidectomy with lymphadenectomy and bilateral adrenalectomy. Conclusions: Even in the presence of its classical features, MEN 2B is a challenging diagnosis. This case emphasizes the complexity of this disease and the need for recognizing this rare, yet potentially lethal condition.
Beatriz Sona Cardoso,Mariana Brito da Cruz,Joana Faria Marques,João Carlos Roque,João Paulo Martins,Rodrigo Cordeiro Malheiro,António Duarte da Mata 대한치과보철학회 2024 The Journal of Advanced Prosthodontics Vol.16 No.2
Purpose. The aim of this study was to evaluate the influence of different 3D dental resins, using a manufacturer recommended printer and a third-party printer, on cellular responses of human gingival cells. Materials and Methods. Three NextDent resins (Denture 3D+, C&B MFH and Crowntec) were used to produce specimens on printers NextDent 5100 (groups ND, NC and NT, respectively) and Phrozen Sonic Mini 4K (groups PD, PC and PT, respectively). Human gingival fibroblasts were cultured and biocompatibility was evaluated on days 1, 3 and 7. IL-6 and IL-8 concentrations were evaluated at 3 days using ELISA. Surface roughness was evaluated by a contact profilometer. SEM and fluorescence micrographs were analyzed at days 1 and 7. Statistical analyses were performed using SPSS and mean differences were tested using ANOVA and post-hoc Tukey tests (P < .05). Results. There was an increase in cellular viability after 7 days in groups PC and PT, when compared to group PD. ND group resulted in higher concentration of IL-6 when compared to PT group. SEM and fluorescence micrographs showed less adhesion and thinner morphology of fibroblasts from group PD. No significant differences were found regarding surface roughness. Conclusion. The use of different printers or resins did not seem to influence surface roughness. NextDent 5100 and Phrozen Sonic Mini 4K produced resins with similar cellular responses in human gingival fibroblasts. However, Denture 3D+ resin resulted in significantly lower biocompatibility, when compared to C&B MFH and Crowntec resins. Further testing is required to support its long-term use, required for complete dentures.