An effective technique for extended proximal contacts in composite resin restorations

Obtaining a firm anatomic contact has been a difficult criteria in placing Class II posterior composite restorations. Various techniques have been developed and a number of products marketed to accomplish this task, but none have combined the necessary qualifications of ease, simplicity, and effectiveness for consistent and predictable results. To address this challenge, two innovative devices--a precontoured (biplanar concave) sectional matrix band and a light--focusing tip-have been developed. Using a clinical case presentation, this article describes the application of these devices to obtain high quality proximal contacts, even in widely separated teeth. The learning objective of this article is to familiarize clinicians with this procedure. The technique is simple and universally applicable with a variety of posterior composite materials and placement methods.     

Effects of metal ions on the substrate-specificity and activity of proton-pumping nicotinamide nucleotide transhydrogenase from Escherichia coli

Nicotinamide nucleotide transhydrogenase catalyzes the reversible reduction of NADP+ by NADH and a concomitant proton translocation. It was demonstrated (Glavas, N.A. and Bragg, P.D. (1995) Biochim. Biophys. Acta 1231, 297-303) that the Escherichia coli transhydrogenase also catalyzed a reduction of the NAD-analogue 3-acetylpyridine-NAD+ (AcPyAD+) by NADH at low pH and in the absence of (added) NADP(H) and high salt concentrations The mechanism of this reaction has as yet not been explained. In the present study, the E. coli transhydrogenase was purified by affinity chromatography through the NADP(H)-site, rendering the pure enzyme free of NADP(H). Using this preparation it was confirmed that the enzyme readily catalyzes the above reaction. Inhibitors specific for the NADP(H)-site, e.g., palmitoyl-Coenzyme A and adenosine-2'-monophosphate-5'-diphosphoribose, strongly inhibited the reduction of AcPyAD+ by NADH, whereas an inhibitor of the NAD(H)-site, adenosine 5'-diphosphoribose, was less inhibitory. This suggests that a lack of metal ions or other ions at low pH induces an unspecific interaction of the NADP(H)-site with AcPyAD+ or NADH, presumably NADH, producing a cyclic reduction of AcPyAD+ by NADH via NAD(H) bound in the NADP(H) site. A stimulation of reduction of AcPyAD+ by NADPH by Mg2+ present during reconstitution of transhydrogenase in phospholipid vesicles was observed, but it is presently unclear whether this effect is related to that seen with the detergent-dispersed enzyme.     

Malignant blue nevus with metastasis to lymph nodes and brain

We report a patient who developed malignant transformation of a cellular blue nevus. At the age of 19 years the congenital, pigmented tumor on the left buttock was histopathologically diagnosed as cellular blue nevus. Thirty years later the tumor dramatically increased in size, involving the entire left buttock within several months. Multiple biopsies revealed the presence of a cellular blue nevus within the papillary dermis and an invasive, pleomorphic pigmented sarcoma in the depth of the tissue spreading into subcutis and skeletal muscle. Both benign and malignant cells were S100+, vimentin+ and HMB-45+, but only the malignant tumor cells stained positive for the proliferating cell nuclear antigen. General examination disclosed multiple metastases in the paraaortal lymph nodes and the retroperitoneum as well as a single brain metastasis. Despite palliative therapy with ionizing radiation and chemotherapy, the patient developed generalized metastases and died within weeks. This case clearly confirms that cellular blue nevi have the potential for malignant transformation and that the malignant variant may behave aggressively just as a malignant melanoma.     

Chronobiologic aspects of ischemic coronary artery disease

Convincing evidence is now available suggesting that several unfavorable cardiovascular events respect a well-defined diurnal pattern in their occurrence. In particular, ischemic heart disease has been widely investigated, and many data indicate a constellation of underlying risk factors whose temporal coincidence might act as triggering factors in the occurrence of acute events. In this paper, the recent knowledge concerning both epidemiology of ischemic heart disease and potentially favoring factors are reviewed from a chronobiological point of view.     

Metabolic abnormalities in developmental dyslexia detected by 1H magnetic resonance spectroscopy

BACKGROUND: Neurological and physiological deficits have been reported in the brain in developmental dyslexia. The temporoparietal cortex has been directly implicated in dyslexic dysfunction, and substantial indirect evidence suggests that the cerebellum is also implicated. We wanted to find out whether the neurological and physiological deficits manifested as biochemical changes in the brain. METHODS: We obtained localised proton magnetic resonance spectra bilaterally from the temporo-parietal cortex and cerebellum of 14 well-defined dyslexic men and 15 control men of similar age. FINDINGS: We found biochemical differences between dyslexic men and controls in the left temporo-parietal lobe (ratio of choline-containing compounds [Cho] to N-acetylaspartate [NA] p< or =0.01) and right cerebellum (Cho/NA, p< or = 0.01; creatine [Cre] to NA p< or =0.05; (not significant). We found lateral biochemical differences in dyslexic men in both these brain regions (Cho/NA in temporo-parietal lobe, left vs right, p< or =0.01; Cre/NA in cerebellum, left vs right, p< or =0.001). We found no such lateral differences in controls. There was no significant relation between the degree of contralateral chemical difference and handedness in dyslexic or control men. INTERPRETATION: We suggest that the observed differences reflect changes in cell density in the temporo-parietal lobe in developmental dyslexia and that the altered cerebral structural symmetry in dyslexia is associated with abnormal development of cells or intracellular connections or both. The cerebellum is biochemically asymmetric in dyslexic men, indicating altered development of this organ. These differences provide direct evidence of the involvement of the cerebellum in dyslexic dysfunction.     

Rapid detection of different RNA respiratory virus species by multiplex RT-PCR: application to clinical specimens

Inconsistent findings from recent mortality studies of workers exposed to magnetic fields have led to calls for more detailed understanding of exposure distributions and metrics in various industries. The authors undertook personal monitoring at an automobile transmission plant to (a) learn if magnetic field exposure differences were present, (b) make assignments for a brain cancer study, and (c) compare two exposure indices. A wide range of average exposures occurred (i.e., 0.016-4.6 microtesla). Within-day variability was also large, and it reached 4 orders of magnitude for some workers. Unexpectedly, demagnetizers were found among the strong sources that contributed to elevated exposures. The authors used conventional summary measures to assign job groups to exposure categories, and they used a new index of exposure irregularity to make alternative assignments. These new assignments appeared to differ from the original ones with respect to work time in each exposure group (i.e., 54% of the work time fell into different exposure categories).     

Absorption of simple nutrients from the in vivo neurally isolated canine jejunum and ileum

BACKGROUND: The effects of intestinal transplantation on enteric absorptive function are not well understood. Our aim was to determine the effects of in situ isolation of the jejunoileum, a large animal model of jejunoileal autotransplantation, on absorption of simple nutrients from the jejunum and ileum separately. METHODS: Four groups of dogs were prepared with modified Thiry-Vella loops: group 1, neurally intact jejunum; group 2, neurally isolated jejunum; group 3, neurally intact ileum; and group 4, neurally isolated ileum. Intestinal loops were perfused with five different isosmolar solutions of NaCl alone, 30 mmol/L glucose, 2.5 mmol/L glycine, 2.5 mmol/L phenylalanine, and 5 mmol/L oleic acid at 1 to 2 weeks and 8 to 9 weeks after operation. RESULTS: Net absorption of water and electrolytes, glucose, glycine, phenylalanine, and oleic acid were not different statistically between neurally intact and neurally isolated intestinal loops at either time point. Ileal loops absorbed more than jejunal loops. CONCLUSIONS: Absorption of simple nutrients from the canine jejunum and ileum is not altered by this model of intestinal autotransplantation. These observations suggest that the extrinsic denervation that accompanies intestinal transplantation does not affect the transport systems for glucose, glycine, phenylalanine, or oleic acid.     

An evaluation of the Ektachem serum lithium method and comparison with flame emission spectrometry

We evaluated the performance of a new colorimetric method in dry chemistry for serum lithium (Li) assay using an Ektachem E500 analyser. Imprecision results were acceptable and the linearity was verified for concentrations within the range of 0.2-3.9 mmol l-1, i.e. y(measured) = 1.02x(calculated) + 0.07, r = 0.99. The Ektachem Li assay was unaffected by potassium (K), calcium (Ca) and magnesium (Mg) at all concentrations tested. Significant interference was caused by sodium (Na) and haemoglobin. Statistically and clinically significant interference was caused by high concentrations of Na (213 mmol l-1) with a bias of 0.20 mmol l-1 (p = 0.02) and by high levels of haemoglobin (280 mumol l-1) with a bias of 0.20 mmol l-1 (p = 0.01). Comparison of serum Li results from 80 patient samples assayed using the Ektachem method with those obtained using the IL943, a flame atomic emission spectrometry (FAES)-based method, gave a regression line equation: Ektachem = 0.95xFAES + 0.13, r = 0.96. The data revealed a mean difference of 0.10 mmol l-1 between the Ektachem and FAES results that was statistically significant (p = 0.01), but clinically negligible. We conclude that the Kodak method provides reliable Li serum results and represents a valid alternative to the FAES method.