Dental materials: 1996 literature review. Part 2

This critical review of the published literature on dental materials for the year 1996 has been compiled by the Dental Materials Panel of the UK. It continues the series of annual reviews started in 1973 and published in the Journal of Dentistry. Emphasis has been placed upon publications which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, resin-bonded bridges and ceramo-metallic restorations, ceramics, denture base resins and soft lining materials, impression materials, implants materials, orthodontic materials, biomechanics and image processing, resin composites and casting investment materials and waxes). Three hundred and thirteen articles have been reviewed.     

Synthesis and hypoxia-selective cytotoxicity of a 2-nitroimidazole mustard

A four-step synthesis of 5-[N,N-bis(2-chloroethyl)amino]-1-methyl-2-nitroimidazole from 1-methyl-2-nitroimidazole is described. This compound showed similar hypoxia-selective cytotoxicity to the dinitrobenzamide mustard SN 23,862 in UV4 cells (ca. 40-fold), and superior selectivity (> 7-fold) in repair-competent AA8 cells.     

Outcome of resuscitation following unexpected apparent stillbirth

There are few data to inform a decision to resuscitate babies who are unexpectedly stillborn. The outcome for 42 successfully resuscitated stillborn children, of whom 62% survived to be discharged home, is reported. Of the survivors, a poor outcome with severe disability was found in 23% (including one postneonatal death), equivocal outcome was found in 15% (two mild hypertonia; two with mild hemiplegia and no associated other disability) and 62% were free of any impairment at follow up 20 months to 8 years later. In 39 (93%) fetal problems had been identified and the resuscitation team was present at delivery. Poor outcome was associated with late return of heart beat, delayed respirations, neonatal acidaemia and early onset of seizures. Of the unexpected apparent stillbirths successfully resuscitated, 52% died or survived severely disabled, 10% had an equivocal outcome, but 36% survived apparently intact. Therefore, vigorous resuscitation is clearly indicated in these circumstances.     

Recipient to donor conduction of atrial tachycardia following orthotopic heart transplantation

Postspinal headache is one of the most common complications of spinal anesthesia and has repeatedly led to controversy concerning needle size and configuration. In an in vitro investigation, we measured cerebrospinal fluid (CSF) leakage with Sprotte, Whitacre, Quincke, and Atraucan needles under physiological conditions in human dura. The puncture characteristics were examined under an electron microscope. The pencil-point needles show 2-3 times less leakage of CSF compared with the cutting Quincke needles of corresponding size. Between the Sprotte and the Whitacre needles, there were no significant differences. The least loss of CSF occurred with the 26-gauge Atraucan needle. Under the electron microscope, a sharply delineated, persistent perforation channel was shown with the Quincke needles, which may explain the high CSF loss. With pencil-point needles, which push the tissue apart bluntly, a large opening on the inside is found, with some tearing of the dura. However, in contrast to the cutting needles, a persistent perforation channel is not manifested. The 26-gauge Atraucan needle, which both cuts and pushes apart conically, shows a relatively discrete opening on the inside, with slight tears in the dura and arachnoidea but without a visible perforation channel. The results of our study show that larger needles (26-gauge Atraucan) that are easier to handle can lead to good and, in some cases even better, puncture results if they have characteristics of both the cutting and the pencil-point needles. IMPLICATIONS: We compared several brands of pencil-point and standard cutting spinal needles of varying sizes. All pencil-point needles had less cerebrospinal fluid leakage, the least loss occurring with 26-gauge Atraucan needles. Electron microscopic examination of the dura after puncture showed characteristic findings with each needle type. We conclude that the combined cutting and pencil-point characteristics seen in the Atraucan needle may have clinical advantages.     

Hemolysin-positive enteroaggregative and cell-detaching Escherichia coli strains cause oncosis of human monocyte-derived macrophages and apoptosis of murine J774 cells

Infection of human monocyte-derived macrophages (HMDM) and J774 cells (murine macrophage cell line) with several enteroaggregative and cytodetaching Escherichia coli (EAggEC and CDEC, respectively) strains demonstrated that some strains could induce macrophage cell death accompanied by release of lactate dehydrogenase activity and interleukin 1beta (IL-1beta) into culture supernatants. The mode of cell death differed in the two types of macrophages. Damage to macrophage plasma membrane integrity without changes in nuclear morphology resulted in cytolysis of HMDM. This mechanism of cell death has been previously described for virulent Shigella infection of HMDM and is termed oncosis. In contrast, infection of J774 cells by EAggEC and CDEC strains resulted in apoptosis. The presence of alpha-hemolysin (Hly) in EAggEC and CDEC strains appears to be critical for both oncosis in HMDM and apoptosis in J774 cells. Bacteria lacking Hly, including Hly- EAggEC strains as well as enterotoxigenic, enteropathogenic, and enterohemorrhagic E. coli strains, behaved like avirulent Shigella flexneri in that the macrophage monolayers were intact, with no release of lactate dehydrogenase activity or IL-1beta into the culture supernatants.     

Inhibited apoptosis and drug resistance in acute myeloid leukaemia

Despite extensive investigation into mechanisms of drug resistance in acute myeloid leukaemia (AML), the aetiology of therapeutic resistance is unclear. We found that five leukaemia cell lines (K562, HL-60, CEM. CEM induced to overexpress bcl-2, and REH) displayed parallel sensitivity to four antileukaemia drugs with different mechanisms of action, with K562 generally being the least sensitive and REH being the most sensitive. The amount of spontaneous apoptosis in the cell lines after serum-free culture paralleled their drug sensitivity: K562 cells displayed the least apoptosis at 24h (2.50 +/- 0.24%) and REH the most (24.47 +/- 8.22%). The extent of spontaneous apoptosis of leukaemic blasts from 39 patients with newly diagnosed de novo AML also correlated with the success of the intensive, infusional cytarabine-based induction therapy. There was a median of 19.5% (range 3.6-64%) apoptotic AML cells after 24 h of serum-free culture in patients who entered a complete remission compared with 4.2% (1.8-7.0%) apoptotic AML cells in patients who did not achieve a complete remission (P = 0.0007). Thus, inhibited apoptosis was associated with both in vitro and in vivo pan-resistance to antileukaemic chemotherapy. The cause of inhibited apoptosis in AML is probably a function of interactions among multiple signals that influence apoptosis. Assessment of spontaneous apoptosis may serve as an important prognostic factor for AML.     

Genetic stability of oral polio vaccine prepared on primary monkey kidney cells or Vero cells--effects of passage in cell culture and the human gastrointestinal tract

The genetic stability of the three Sabin oral poliovaccine (OPV) strains produced on either primary monkey kidney (VK) or Vero cell substrates was compared in vivo and in vitro by measuring the rate at which the bases most strongly associated with attenuation and reversion to neurovirulence (positions 480, 481, and 472 in the 5' non-coding region of Sabin 1, 2 and 3 respectively, and 2034 in VP3 of Sabin 3) reverted during passage of the vaccine strains in the gastrointestinal tract of primary vaccinees and in cell culture. For the in vivo study, the poliovirus excretion patterns of 21 infants receiving OPV produced on either VK or Vero cells were followed for 21 days. No significant differences in either the frequency of excretion or the rate of reversion were observed between the two vaccine groups. The rate of accumulation of revertants during passage in vitro was compared for the three Sabin strains passaged 10 times in either VK or Vero cells. For types 1 and 3, revertants accumulated faster upon passage through VK cells compared with passage through Vero cells. Type 2 appeared to be stable as no revertants were detected in either cell type. Results of this study suggest that the use of Vero as opposed to VK cells as substrate for the manufacture of OPV does not negatively influence the genetic stability of the three Sabin OPV strains in vivo or in vitro.     

A clinicobacteriological study on leucorrhoea

The pathogens like Trichomonas vaginalis (4.5%), N gonorrhoeae (2.7%) and C albicans (6.7%) were exclusively present in leucorrhoea. The other potential agents with their respective percentages in normal women and cases of leucorrhoea were U urealyticum (21.2% and 50.2%), actinomyces (29.7% and 41.6%), Chlamydia trachomatis (17% and 48.8%), candida-like organisms (CLO) (1.2% and 9.5%) and non-group B streptococci (4.2% and 16.7%). The percentages of urethral syndrome (65.8%), vaginal irritation (63.4%), sore vulva (17%), cervicitis (13.4%), cervical erosion (11%) of the STD clinic were more than those of gynaecological cases. The latter group more often revealed infertility (15.8%) and pelvic inflammatory disease (13.6%). The exclusive isolation rate of N gonorrhoeae (7.3%) and prevalence of G vaginalis (19.5%) and Trichomonas vaginalis (8.5%) in the STD clinic were notable. The cases of gynaecological clinic more commonly showed C albicans (8%) and CLO (13.6%). Significant differences pertaining to U urealyticum (leucorrhoea and inapparent group p < 0.01; leucorrhoea and normal cases p < 0.01), M hominis (leucorrhoea and inapparent group p < 0.05; leucorrhoea and normal cases p < 0.01), Chlamydia trachomatis (leucorrhoea and normal cases p < 0.01) and also actinomyces (leucorrhoea and normal cases p < 0.01; inapparent and normal cases p < 0.05) were recorded. There was conspicuous association of U urealyticum, M hominis, G vaginalis, Chlamydia trachomatis, CLO and actinomyces with leucorrhoea. An almost exclusive presence of Staph aureus, Esch coli and Klebsiella in cases of leucorrhoea appeared meaningful.     

Regulation of the glial Na+-dependent glutamate transporters by cyclic AMP analogs and neurons

Sodium-dependent transport into astrocytes is critical for maintaining the extracellular concentrations of glutamate below toxic levels in the central nervous system. In this study, the expression of the glial glutamate transporters GLT-1 and GLAST was studied in primary cultures derived from cortical tissue. In primary astrocytes, GLAST protein levels were approximately one half of those observed in cortical tissue, but GLT-1 protein was present at very low levels compared with cortical tissue. Maintenance of these astrocytes in medium supplemented with dibutyryl-cAMP (dbcAMP) caused a dramatic change in cell morphology, increased GLT-1 and GLAST mRNA levels approximately 5-fold, increased GLAST protein approximately 2-fold, and increased GLT-1 protein >/=8-20-fold. These increases in protein expression were accompanied by 2-fold increases in the Vmax and Km values for Na+-dependent L-[3H]glutamate transport activity. Although GLT-1 is sensitive to inhibition by dihydrokainate in heterologous expression systems, no dihydrokainate sensitivity was observed in astrocyte cultures that expressed GLT-1. Biotinylation with a membrane-impermeant reagent, separation of the biotinylated/cell surface proteins, and subsequent Western blotting demonstrated that both GLT-1 and GLAST were present at the cell surface. Coculturing of astrocytes with neurons also induced expression of GLT-1, which colocalized with the glial specific marker, glial fibrillary acidic protein. Neurons induced a small increase in GLAST protein. Several studies were performed to examine the mechanism by which neurons regulate expression of the glial transporters. Three different protein kinase A (PKA) antagonists did not block the effect of neurons on glial expression of GLT-1 protein, but the addition of dbcAMP to mixed cultures of neurons and astrocytes did not cause GLT-1 protein to increase further. This suggests that neurons do not regulate GLT-1 by activation of PKA but that neurons and dbcAMP regulate GLT-1 protein through convergent pathways. As was observed with GLT-1, the increases in GLAST protein observed in cocultures were not blocked by PKA antagonists, but unlike GLT-1, the addition of dbcAMP to mixed cultures of neurons and astrocytes caused GLAST protein to increase approximately 2-fold. Neurons separated from astrocytes with a semipermeable membrane increased GLT-1 protein, indicating that the effect of neurons was mediated by a diffusible molecule. Treatment of cocultures with high concentrations of either N-methyl-D-aspartate or glutamate killed the neurons, caused GLT-1 protein to decrease, and caused GLAST protein to increase. These studies suggest that GLT-1 and GLAST protein are regulated independently in astrocyte cultures and that a diffusible molecule secreted by neurons induces expression of GLT-1 in astrocytes.