Histological evaluation of therapy using a calcium hydroxide dressing for teeth with incompletely formed apices and periapical lesions

Periapical tissue response was evaluated histologically in teeth of 6-month-old dogs with incomplete root formation and periapical lesions in order to compare the effects of two calcium hydroxide-containing pastes prepared with different vehicles on induced root apex formation and repair of the periapical region. A group of teeth with no root canal dressing was used as control. After induction of the periapical lesion, the root canals were instrumented and filled with one of the two pastes (Calen and Calasept), which were renewed monthly for 90 days. At the end of the follow-up period (3 months), the animals were killed. Block sections from the actual areas were dissected free and prepared for histopathological analysis. Both calcium hydroxide pastes helped induce apical sealing and repair of the region, but the Calen paste yielded better results than Calasept. The induced mineralized tissue was predominantly of the cementoid type after the use of both pastes, but the inflammatory infiltrate was significantly less intense with the use of the Calen paste. In the control group, the absence of a root canal dressing impaired the process of periapical repair and yielded no apical root closure in any of the cases analyzed.     

Treatment of root perforations with calcium hydroxide and SuperEBA cement: a clinical report

Complete nucleotide sequence of a plasmid isolated from Enterobacter agglomerans has been determined. The plasmid, called pPIGDM1, consists of 2495 base pairs. The analysis of its nucleotide sequence suggested that pPIGDM1 may be a ColE1-like replicon. We confirmed this hypothesis by constructing a pPIGDM1-derived plasmid harboring the cat gene (pBW4), which could be introduced into Escherichia coli cells, and demonstrating that pBW4 cannot replicate in the absence of the polA function and that its copy number is significantly decreased in the pcnB mutant. Like some other ColE1-type replicons (e.g., pBR322), pPIGDM1-derived plasmids can be amplified both by chloramphenicol method and in isoleucine-starved relA mutants but not in relA+ bacteria. Inactivation of the putative rom gene by insertion of an amplicillin-resistance gene resulted in significant increase in pPIGDM1-derived plasmid copy number in E. coli-despite the fact that amino acid sequence of the putative RNA 1 modulator (Rom) protein is only 55.7% identical to the ColE1 analog. The pPIGDM1-derived rom-like coding sequence is also homologous to the rom-like gene present in the Proteus vulgaris plasmid pPvul. We suggest to group all these gene products into a new family called ROMS (RNA one modulators). Since a pPIGDM1-derived plasmid is compatible with other ColE1-like replicons (pMB1-, p15A, RSF1030-, and CloDF13-derived) in E. coli, one may consider pPIGDM1 as a progenitor of new cloning vehicles compatible with most (if not all) of currently used plasmid vectors. Moreover, this plasmid may serve as a source of the new rom-like gene coding for a protein useful in investigation of RNA-protein interactions. A role for the pPIGDM1 plasmid in the host strain is not known.     

Examination of the antibacterial action of metronidazole against vibrios and Campylobacter (author's transl)

The in vitro antibacterial activity of metronidazole was tested against 70 strains of aerobic vibrios (V. cholerae biotype cholerae, V. cholerae biotype eltor, NAG-vibrios, V. parahaemolyticus, v. alginolyticus) and 30 strains of microaerophilic Campylobacter (C. fetus subsp. fetus, C. fetus subsp. intestinalis and C. fetus subsp. jejuni). All strains of aerobic vibrios proved to be resistant (MIC 100 micrograms/ml) in contrast to campylobacter strains which were sensitive (MIC 1-4 micrograms/ml) to the drug. The findings confirm that metronidazole can be considered to be a selective inhibitor of anaerobic microorganisms, but its action is not restricted to obligate anaerobes.     

Laboratory evaluation of BL-S786, a cephalosporin with broad-spectrum antibacterial activity

Biological and physicochemical properties of BL-S786 were compared with those of cephalothin, cephaloridine, and cefazolin. With few exceptions, BL-S786 was more active than the reference compounds against major gram-negative pathogenic species and its antibacterial spectrum was broader than that of cephalosporins currently available for clinical use. Although BL-S786 was generally less active than the control cephalosporins against gram-positive pathogens, it inhibited their growth at concentrations that should readily be achieved in humans after standard parenteral dosage. Streptococcus faecalis, a species relatively unsusceptible to cephalosporins in general, was an exception. BL-S786 was an effective bactericidal agent for strains of various gram-negative organisms. After intramuscular administration to mice, BL-S786 achieved high concentrations in blood, and its biological half-life was longer than that of the other three cephalosporins.     

Relationship between intracellular calcium and oxygen consumption: effects of perfusion pressure, extracellular calcium, dobutamine, and nifedipine

All of the mechanisms that connect the cardiac mechanical work load with energy production have not been clearly defined. The purpose of this study was to evaluate the relationship between intracellular calcium and oxygen consumption in intact hearts, to further understand this relationship. Intracellular calcium was measured in isolated nonworking perfused rat hearts loaded with Indo-1 by means of a surface fluorometry technique. Glucose was used as a substrate. Myocardial contraction and oxygen consumption were modulated by perfusion pressure (80, 110, and 140 cm of water), extracellular calcium (1, 2, 3, and 4 mmol/L), dobutamine (10(-6) mol/L), and nifedipine (10(-6) mol/L). With all of these interventions there was a close correlation between intracellular calcium (systolic, diastolic, and amplitude) and oxygen consumption or left ventricular developed pressure. Observations in this study support the hypothesis that intracellular calcium plays a regulatory role in the link between cardiac mechanics and energy production.     

Assessment of the skin sensitization potential of topical medicaments using the local lymph node assay: an interlaboratory evaluation

The murine local lymph node assay (LLNA) is a method for the predictive identification of chemicals that have a potential to cause skin sensitization. Activity is measured as a function of lymph node cell (LNC) proliferative responses stimulated by topical application of test chemicals. Those chemicals that induce a threefold or greater increase in LNC proliferation compared with concurrent vehicle controls are classified as skin sensitizers. In the present investigations we have evaluated further the reliability and accuracy of the LLNA. In the context of an international interlaboratory trial the sensitization potentials of six materials with a history of use in topical medicaments have been evaluated: benzoyl peroxide, hydroquinone, penicillin G, streptomycin sulfate, ethylenediamine dihydrochloride, and methyl salicylate. Each chemical was analyzed in the LLNA by all five laboratories. Either the standard LLNA protocol or minor modifications of it were used. Benzoyl peroxide and hydroquinone, both human contact allergens, elicited strong LLNA responses in each laboratory. Penicillin G, another material shown previously to cause allergic contact dermatitis in humans, was also positive in all laboratories. Streptomycin sulfate induced equivocal responses, in that this material provoked a positive LLNA response in only one of the five laboratories, and then only at the highest concentration tested. Ethylenediamine dihydrochloride dissolved in a 3:1 mixture of acetone with water, or in 4:1 acetone:olive oil (one laboratory), was uniformly negative. However, limited further testing with the free base of ethylene diamine yielded a positive LLNA response when applied in acetone:olive oil (AOO). Finally, methyl salicylate, a nonsensitizing skin irritant, was negative at all test concentrations in each laboratory. Collectively these data serve to confirm that the local lymph node assay is sufficiently robust to yield equivalent results when performed independently in separate laboratories and indicate also that the LLNA is of value in assessing the skin sensitization potential of topical medicaments.     

Hepatitis associated with terbinafine therapy: three case reports and a review of the literature

Single-rooted premolar teeth, stained with blood utilizing the technique devised by Freccia & Peters (1981), were subjected to traditional and non-peroxide bleaching agents. Colour changes were recorded over a period of 7 days using a Speedmaster R75-CP Reflection Densitometer. The most efficient removal of staining occurred after the application of 30% hydrogen peroxide, with sodium perborate being 75% as effective. All bleaching agents realized their optimum efficacy within the first 3 days. A combination of three enzymes (amylase, lipase and trypsin) with disodium edetate was not as effective as the routine bleaching agents; however, the combination did have a modifying effect on the blood stains. It is suggested that other non-peroxide agents should be investigated to determine their efficacy in removing staining from experimentally induced blood-stained teeth.     

The effect of aluminium hydroxide orally on calcium, phosphorus and aluminium metabolism in normal subjects

1. Five normal subjects were given 100 ml of aluminium hydroxide gel per day for 28 days. 2. The phosphorus balance became more positive in one subject, less negative in two and changed from negative to positive in the other two subjects. This was accompanied by a rise in the concentration of the fasting morning plasma phosphorus. Calcium balance did not change. 3. The normal subjects absorbed 0-3-3-6 mmol of aluminium/day, which is significantly less than that absorbed by five patients with chronic renal failure, three of whom were studied before, and two after, the observations on the normal subjects had been completed. 4. In a further five normal subjects on 100 ml of aluminium hydroxide gel/day the 08.00 hours concentration of plasma phosphorus did not fall, though there was a fall at 11.00, 14.00 and 17.00 hours.     

Combination amoxycillin and metronidazole with famotidine in the eradication of Helicobacter pylori--a randomized, double-blind comparison of a three times daily and twice daily regimen

OBJECTIVES: To determine the efficacy of a three times daily (t.i.d.) versus a twice daily (b.i.d.) regimen of combination amoxycillin and metronidazole and famotidine in the eradication of Helicobacter pylori and the influence of metronidazole resistance on the outcome of treatment. PATIENTS: Patients selected had unequivocal evidence of H. pylori infection based on the urease test, culture and histology and had either peptic ulcer disease or non-ulcer dyspepsia. DESIGN: The study was a comparative and double-blind study and patients were randomized to receive either amoxycillin 750 mg t.i.d. and metronidazole 500 mg t.i.d. for 12 days or amoxycillin 1000 mg b.i.d. and metronidazole 500 mg b.i.d. for 12 days. Both groups also received famotidine 40 mg for 6 weeks. MAIN OUTCOME MEASURE: Patients were assessed for successful eradication, defined as absence of bacteria in all tests, at least 4 weeks after completion of antibiotic therapy by repeat gastroscopy. RESULTS: One hundred and twenty-nine patients were recruited for the study. Two patients defaulted follow-up, two patients were withdrawn from the study and six patients were found to be non-compliant with medications. The eradication rates of the t.i.d. regimen was higher than the b.i.d. regimen (per protocol (PP) analysis: 83.3% (50/60) vs. 76.3% (45/59), P=0.337; intention-to-treat (ITT) analysis: 78.5% (51/65) vs. 75.0% (48/64), P=0.642). Seventy-five patients had pre-treatment cultures checked for metronidazole resistance, 33 (44.0%) were found to be resistant. Acquired resistance occurred in 3/40 (7.5%) patients. Eradication rates of metronidazole-sensitive and metronidazole-resistant patients: t.i.d. regimen - 100% (17/17) and 88.2% (15/17), b.i.d. regimen - 19/21 (90.5%) and 11/15 (73.3%). Side effects were reported in up to 70% of patients but were mild and tolerable in the majority. Two patients were withdrawn from the study because of a fixed drug eruption in one and generalized macular rash in the other. CONCLUSION: Combination amoxycillin and metronidazole is effective in eradicating H. pylori. There was a tendency for the t.i.d. regimen to be better than the b.i.d. regimen and for metronidazole-resistant infections to be associated with a lower eradication rate but these differences did not reach statistical significance.     

Therapy with facially injured clients: A study of memory, evaluation, and exposure effects.

Although the number of people with facial injury increases due to modern warfare, studies that examine how clinicians are impacted by viewing facial injury are scarce. This study included 63 participants and investigated the impact viewing facial injury would have on recall and evaluation in a simulated therapist–client interaction. A 2 × 2 between-subjects design assessed facial injury status and prior exposure. All conditions were exposed to the same pseudoclient narrative that was delivered via audiotape. Recall of the facts regarding the client's narrative was assessed with 20 multiple-choice questions. Client evaluation was based on 3 factors (sympathy, capability, and likability) that emerged from a 16 statement inventory designed for the current study. A 2 × 2 analysis of variance conducted on the memory measure revealed that participants who had previewed a photo of an uninjured client recalled significantly less from the narrative than conditions without preview to the uninjured client and with preview to the injured client. A multivariate analysis of variance on the evaluation factors revealed no significant effects. Although the authors expected facial injury would have a negative effect on recall, instead facial injury created an enhancement effect. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Differential effects of indomethacin on the sheep ovary: prostaglandin biosynthesis, intracellular calcium, apoptosis, and ovulation

Cells of the apical wall of the dominant follicle and contiguous ovarian surface epithelium become apoptotic with the approach of ovulation in the sheep. It was hypothesized that indomethacin, an established inhibitor of prostaglandin biosynthesis and ovulation, would protect apical ovarian cells from programmed death. The anovulatory potencies of two systemic doses of indomethacin (200 and 800 mg) were tested in gonadotropin-stimulated ewes. A complete blockade of ovulation occurred at the higher dose of indomethacin. Ovulation was not inhibited by 200 mg indomethacin. Both doses of drug suppressed follicular prostaglandin production below pregonadotropin levels. Immunofluorescence detection of digoxigenin end-labeled (fragmented) DNA was used as a marker of apoptosis among ovarian surface epithelial and granulosa cells recovered from the optical hemisphere of preovulatory ovine follicles. Cellular DNA fragmentation was averted in animals given 800 mg indomethacin, whereas apoptosis ensued after 200 mg. A sustained increase in cytosolic calcium is generally a prerequisite to apoptotic DNA fragmentation and cell death. Indeed, intracellular calcium, detected by fluorescence of fura-2, was elevated in ovarian cells of animals destined to ovulate (controls, 200 mg indomethacin) in comparison to (safeguarded) cells of anovulatory ewes (800 mg indomethacin). These observations provide circumstantial evidence that apical ovarian cell degeneration by calcium-mediated apoptosis is a determinant of follicular instability and rupture, but that these events are unrelated to the gonadotropin-induced rise in prostanoid production characteristic of preovulatory follicles.     

Costs and charges associated with three alternative techniques of hysterectomy

BACKGROUND: Many hysterectomies are now performed by a laparoscopically assisted vaginal technique. This procedure is controversial, partly because of concern about cost. We studied hospital charges and costs for the procedure as compared with those for total abdominal hysterectomy and total vaginal hysterectomy in clinically similar groups of patients. METHODS: From hospital-discharge data and patients' charts, we identified hysterectomies performed in 1993 and 1994 by 96 surgeons at a community teaching hospital to treat benign conditions. The patients were grouped according to the surgical procedures performed in conjunction with the hysterectomy. Data on hospital charges and cost-to-charge ratios for 64 hospital cost centers were used to assess charges and costs for specific resources, as well as for the hospitalization overall. RESULTS: Of 1049 patients studied, 26 percent underwent laparoscopically assisted vaginal hysterectomy, 54 percent underwent abdominal hysterectomy, and 20 percent underwent vaginal hysterectomy. The average hospital stays were 2.6, 3.9, and 2.9 days, respectively, and the mean total charges (facility charges plus professional fees) for the hospitalizations were $6,116, $5,084, and $4,221 (P<0.001 for the comparison of the laparoscopic technique with both other techniques). The mean facility costs were $4,914, $3,954, and $3,116, respectively (P<0.001 for the same comparison), with similar findings in all subgroups. The higher charges and costs for laparoscopically assisted vaginal hysterectomy were due to higher supply costs, particularly when disposable supplies were used, and to longer operating-room time. CONCLUSIONS: Despite shorter hospital stays, in-hospital charges and costs for laparoscopically assisted vaginal hysterectomy are higher than for either alternative procedure, because of the disposable supplies that are typically used and the longer operating-room time.     

Disinfection by calcium hydroxide pastes of dentinal tubules infected with two obligate and one facultative anaerobic bacteria

Bovine dentine cylinders were experimentally infected with Actinomyces israelii, Fusobacterium nucleatum, or Enterococcus faecalis. The latter is a facultative anaerobic bacteria and the others are obligate anaerobes commonly found in endodontic infections. The infected specimens were exposed to pastes of calcium hydroxide mixed with saline solution or camphorated paramonochlorophenol for periods of 1 h, 1 day, and 1 week. The viability of bacteria after these exposure times was evaluated by specimen incubation in culture medium to compare the effectiveness of the pastes in disinfecting dentinal tubules. The calcium hydroxide/camphorated paramonochlorophenol paste effectively killed bacteria in the tubules after a 1-h period of exposure, except for E. faecalis that required one day of exposure. In contrast, the calcium hydroxide/saline paste was ineffective against E. faecalis and F. nucleatum even after 1 week of exposure. The results showed that camphorated paramonochlorophenol increased the antibacterial effects of calcium hydroxide.     

Chest discomfort associated with liposomal amphotericin B: report of three cases and review of the literature

Liposomal formulations of amphotericin B are designed to maintain therapeutic efficacy of amphotericin B deoxycholate while reducing its associated toxicities. In three patients chest discomfort occurred during planned 1-hour infusions of liposomal amphotericin B (AmBisome) 3 mg/kg/day during an open-label trial. The first patient experienced chest tightness and difficulty breathing and the second had dyspnea and acute hypoxia, both within 10 minutes of the start of the infusion. The third patient complained of chest pain 5 minutes after the start of two infusions. All symptoms resolved on terminating therapy. Two patients were later rechallenged with slower infusions and tolerated the drug well. A review of the English-language literature revealed only two other case reports of infusion-related chest or pulmonary reactions with the drug, although similar reactions were noted in several reports of clinical trials. Further review of the literature revealed reports of chest and pulmonary adverse events with other liposomal formulations of amphotericin B, liposomal daunorubicin, liposomal doxorubicin, and liposomes. The pathophysiology of such reactions remains unclear, and premedication with diphenhydramine did not completely prevent this reaction in one of our patients. We recommend infusing liposomal amphotericin B over at least 2 hours with careful monitoring for adverse reactions.     

Oxidative stress in Staphylococcus aureus associated to the cleavage of an isoxazolylnaphthoquinoneimine with antibacterial capacity

Staphylococcus aureus was inhibited by exposure to 2-hydroxy-N-(3,4-dimethyl-5-isoxazolyl)-1,4-naphthoquinone-4-imine (Q1). This compound was cleavaged in the presence of bacteria and an efflux of isoxazolamine was detected whereas in the S. aureus membrane and cytoplasm was observed an absorption band similar to that of the bencenoid ring. Non-viable bacteria showed intact Q1 intracellularly and in the membrane. Antistaphylococcus effect was associated to Q1 interaction with the respiratory chain, the oxidative metabolites were stimulated; there was cellular injury simultaneous to reduction of antibiotic molecule and efflux of isoxazolamine. The bacteria treated with Q1 increased its oxygen consumption and superoxide anion generation. Superoxide dismutase (SOD) production was stimulated, but it was principally extracellular in S. aureus. Escherichia coli, a species resistant to the antibiotic, did not reduce Q1 and showed lower superoxide anion generation; besides, there was an increase of intracellular SOD with extracellular decrease.     

Conservative treatment of a case of periapical lesion with complications. Report of a case and calcium hydroxide therapy

A case and treatment of extraoral fistula on the chin-caused by necrotic pulp of lower left canine--is being presented. In this case an endodontic origin should always be considered from the aspect of differential diagnosis. Nonsurgical endodontic therapy, sometimes complimented by surgery, or extraction are the treatment modalities of these cases. For the treatment calcium hydroxide powder mixed with chlorhexidin gluckonat (0.1%) was used. Usage of calcium hydroxide paste was leaded to rapid and successful healing of extraoral lesions communicating with necrotic tooth.     

Estrogen, the ovary, and neutotransmitters: factors associated with aging

Our studies in the C57BL/6J mouse have been designed to examine the interactions of aging and the ovary, and their mutual effects on neuroendocrine function. In the pituitary, ovarian status and not age determines responsiveness to gonadotropin hormone releasing hormone (GnRH), but estrogen (E2) is an important mediator in CNS changes, and removal of the ovary (OVX) is deleterious to the neuroendocrine hypothalamus. OVX for just six days in young animals results in synaptic loss between noradrenergic terminals and gonadotropin hormone releasing hormone (GnRH) neurons. Long-term OVX, hypothesized to protect against neuroendocrine aging, fails to guard against any studied age-related changes. Some age-related changes occur as early as midlife. Although neuron number remains constant at middle age, opiatergic neurons undergo significant functional changes by producing opiate antagonist peptides. This change appears to be caused by alterations in the prohormone convertases, which cleave propeptide to peptide. Altered peptides may trigger the loss of reproductive capacity. The midlife shift in opiate peptide production is a component of natural developmental processes that begin in the neonate and continue through old age. In the cholinergic system, E2 mediates numbers of cholinergic receptors, cholinergic neurons, and cholinergic-modulated memory systems in both young and old animals. Regardless of age, ovarian steroids, if present at physiologic levels, are beneficial to the neuroendocrine CNS, and long-term deprivation from ovarian-produced factors is deleterious in the systems we have examined. Our studies have shown that deprivation from ovarian steroid hormones in the female appears to be a major factor in the health of the CNS and in events associated with aging.     

Characteristics associated with real and made-up events: The effects of event valence, event elaboration, and individual differences.

In three studies, participants rated both real and made-up personal events on several different characteristics. These included meta-cognitive beliefs about the perceived realness and typicality of these events, imagery ratings of visual detail, and emotional ratings of intensity and feelings. Studies 1 and 2 explored the impact of event valence (pleasant versus unpleasant) on these characteristics, whereas Study 3 focused on the effects of event elaboration involving guided imagery and journaling techniques. All three studies also included consideration of individual difference factors that might either enhance or attenuate the ratings that were obtained. Both Studies 1 and 2 found that pleasant events (be they real or made-up), were viewed as more typical, and more likely to have happened and be true, than unpleasant events. This pattern of meta-cognitive judgments provided support for a general positivity hypothesis, which proposes that most individuals orient towards and emphasize pleasant rather than unpleasant life experience and events. In contrast, the imagery-related components of these events, such as visual details, location, and time, were much less sensitive to the manipulation of event valence. Strong imagery-related effects, however, were noted when events were elaborated in the final study. Furthermore, this event elaboration manipulation also resulted in heightened meta-cognitive judgments of typicality, likelihood of the event having happened, and of being true. Finally, across all three studies, a series of correlational analyses indicated that the individual difference factors did not have any systematic effect on any of the event characteristic ratings. However, when event valence was not specifically manipulated (in Study 3), depressed individuals spontaneously provided twice as many unpleasant personal events as nondepressed individuals. These findings were then discussed in terms of source-confusion issues regarding personal memory accuracy, as well as the further extension of a recent model of autobiographical memory to incorporate event properties such as valence and elaboration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)