[A study on the relationship between pathologic morphology and clinical prognosis of renal cell carcinoma]. One hundred and six cases of renal cell carcinoma (RCC) were studied with an objective to investigate the effects of clinical stages, histological patterns (grading), cell types, nuclear grading and tumor sizes on the postoperative survival time of the patients. The results showed that there were no statistical differences in the postoperative survival time among different histological patterns and among different cellular types, such as clear cell, granular cell and mixed cell. But those with either diffuse sarcomatoid pattern or undifferentiated cell type had poor prognosis. The patients with tumor size greater than 10 cm in diameter had poor prognosis. The prognosis-deciding factors for RCC patients were the clinical staging and nuclear grading. We suggest that the nuclear grading of RCC be noted in every pathological report, so as to provide reference for clinical evaluation of the prognosis and further treatment.


[Pathological study on epithelioid sarcoma]. Thirteen cases of epithelioid sarcoma were studied by light microscopy (LM), electron microscopy and immunohistochemical technique. LM revealed a nodular pattern of the tumor cells, which consisted of various degrees of a typical epithelioid cells and plump spindle-shaped cells. Irregular necrosis was seen in the centre of some nodules. Ultrastructurally the tumor cells exhibited abundant intermediate filaments, desmosome-like cell junctions and small intercellular spaces surrounded by microvilli. Immunohistochemically, there was positivity for vimentin and keratin. The author discussed diagnosis, differential diagnosis and histogenesis of epithelioid sarcoma.


[Pulmonary function disturbances in patients with hepatic cirrhosis]. The results of five pulmonary function tests on 52 patients with uncompensated hepatic cirrhosis were presented. Compared with matched healthy adults, the patients had decreased values of VC, TLC and DLCO, and their RV/TLC increased (P < 0.05-0.001). Possible pathogenic factors were investigated. The ascites showed evident influences on pulmonary function. In addition to the disorders detected by the above 4 tests, FRC decreased in the patients with ascites. A comparison between the patients with albumin below 30g/L and the patients with albumin above 30g/L revealed that reduced plasma albumin also played role in decreasing VC, TLC and DLCO. Besides the effects of ascites, severe varices of esophagus should have relation to the increase of RV/TLC and the decrease of DLCO.


Inferior alveolar nerve transposition in combination with Brånemark implant treatment. The surgical protocol for inferior alveolar nerve transposition together with the Brånemark implant treatment is described. The short-term follow-up results of the first ten procedures are presented and show an initial 2- to 3-week duration of anesthesia. In all regions treated, signs of paresthesia/hypoesthesia have been registered for 1 to 7 months. After 6 months, seven of the regions recovered completely with regard to nerve sensation.


Periodontal regenerative therapy with coverage of previously restored root surfaces: case reports. Two case reports are presented to demonstrate a treatment that restores proper esthetics, cures hypersensitivity, and enhances periodontal support for cases of root caries or failing Class V restorations associated with gingival recessions. The procedure involves removing the existing restoration, elevating a trapezium-shaped full thickness flap, root planing to achieve a desired concave shape, and placing a barrier membrane. In both cases, satisfying clinical results have been maintained for 18 months.


Jawbone enlargement using immediate implant placement associated with a split-crest technique and guided tissue regeneration. Five patients with sufficient vertical bone height but insufficient bone width for implant placement were chosen for treatment with a split-crest technique combined with guided tissue regeneration. The surgical technique involved splitting the alveolar ridge longitudinally in two parts, provoking a greenstick fracture. A chisel was then used to make a fine cut and spread apart the two cortical plates. Implants were then placed. Implants and defects were covered with expanded polytetrafluoroethylene membranes. Biometrical examination showed a gain in bone width, varying between 1 and 4 mm; maxillary sites showed greater ridge enlargement. Histologic examination showed regeneration of bone tissue between the two portions of the split crest. This membrane technique could be effective and predictable for horizontal ridge augmentation associated with immediate implant placement.


Clinical results and guidelines on Steri-Oss endosseous implants. A statistical study of the Steri-Oss implant system, concerning 673 implants placed in 280 patients in the course of a 5-year period, allows a therapeutic proposal to be made that will optimize the success rate of osseointegration. The study revealed indications specific to each type of implant, according to the depth and density of available bone. The use of titanium screws is recommended whenever bone quality is type I. In all other cases, where the density of bone decreases and approaches type IV, especially in the posterior maxilla, cylindrical hydroxyapatite-coated implants are recommended.


Achieving ideal esthetics in osseointegrated prostheses. Part II. The single unit. There are several advantages to the CeraOne single-tooth abutment. It seats directly onto the fixture, forming a nonrotating joint. A new type of gold alloy screw that can be tightened to 32 N/cm is used. In addition, the restoration is constructed on a prefabricated ceramic cap onto which porcelain is directly baked. A case report illustrates the technique and the highly esthetic results of such single-tooth replacement.


Evaluation of an in vitro invasion assay for use on solid tissue samples and cultured cells. An invasion assay, developed for monitoring the in vitro penetration of reconstituted basement membrane, matrigel, was modified and successfully applied to solid tumours, normal tissues as well as a variety of normal and tumour cell lines. However, we found that some normal fibroblasts were capable of in vitro invasion whilst some malignant cell lines with invasive capacity in vivo did not penetrate the matrigel. Nevertheless, this method can distinguish invasive capacity within a tumour model, and as a consequence may be used to elucidate some of the biochemical mechanisms in the invasion process comparing cells grown both in vitro and in vivo. Since the method does not always correlate with invasion in vivo the results must be interpreted with caution.


Activation of protein kinase A increases the in vitro invasion, migration, and adherence to reconstituted basement membrane by Lewis lung carcinoma tumor cells. Prostaglandin E2 (PGE2) stimulated in vitro invasion, migration, and adherence to reconstituted basement membrane by metastatic Lewis lung carcinoma (LLC) clones, but this stimulation was blocked by protein kinase A (PKA) inhibitors and by expression of a transfected mutant RI alpha which blocks PKA activation. In vitro migration and adherence of metastatic LLC transfectants was heightened by expression of a transfected C alpha gene and further heightened by Zn2+ induction of the expression vector. Nonmetastatic LLC were not migratory nor invasive. However, nonmetastatic LLC that were stably transfected with a C alpha gene were both migratory and invasive, particularly when C alpha expression was further induced with Zn2+. The results of these in vitro studies show that PKA can enhance the metastatic characteristics of LLC.


Preferential growth stimulation of metastatic rat mammary adenocarcinoma cells by organ-derived syngeneic fibroblasts in vitro. To determine whether organ-derived fibroblasts differentially affect the growth of cells from tumors that preferentially metastasize to specific organs, we investigated the effect of medium conditioned with primary cultured rat fibroblasts from various organs on the in vitro growth of metastatic cell lines and clones of the rat 13762NF mammary adenocarcinoma. The conditioned medium from fibroblasts derived from rat mammary fat pad differentially stimulated tumor cell growth in monolayer culture and clonogenic growth in soft agarose of the highly metastatic clone MTLn3 in a dose-dependent manner. Conditioned medium from fibroblasts derived from the lung and liver also stimulated the growth of clone MTLn3 cells but to a lesser extent than did mammary fat pad fibroblasts. In contrast, poorly metastatic cell clones (MTC, MTPa) did not respond to the growth stimulatory factor(s) from the fibroblast-conditioned medium. The factor(s) responsible for the growth stimulation were inactivated by heat and trypsin treatment and inhibited by low pH and cycloheximide. The result suggest that fibroblasts in different organs have different effects on tumor cell growth, and they may determine, in part, the organ specificity of tumor development and metastasis.


Fibronectin degradation by human gastric carcinoma cell lines and its associated proteases in relation to stromal invasion in nude mice. The invasiveness of human gastric carcinoma cell lines (MKN45 and MKN28) in the subcutaneous tissue of nude mice and the degrading capacities of extracellular matrix (ECM) were studied. MKN45 cells were more invasive than were the MKN28 cells. Immunostaining revealed dense lamellar accumulation of fibronectin (FN) around the tumors. Along the front of the invasive MKN45 growth, however, the FN fibers were discontinuous and/or had completely vanished; the MKN28 tumor showed no FN fiber disconnection. ECM components other than FN never displayed such peritumoral massive accumulation. Cocultivation of human fibroblasts with MKN45 cells, more evidently than with MKN28 cells, revealed degradation of FN produced by fibroblasts in contact with each tumor. Both cell lines produced several FN-degrading enzymes in serum-free cultures. Proteases from the MKN45 medium were more active than were those of MKN28 in urokinase-type plasminogen activator (uPA) and metal-dependent serine proteinase-like proteases of 75 and 68 kDa in molecular weight (MW). Type I collagen-degrading 48-kDa protease was also detected from MKN45 medium but not from the MKN28 medium. MKN28 cells secreted other kinds of FN-degrading enzymes, estimated at approximate MWs of 29 and 100-150 kDa. We found no distinct differences in capacity to produce ECM components or ability to adhere to purified ECM components between these two cell lines. From these results we conclude that the stromal invasion of these cells into the subcutaneous tissue of nude mice is profoundly related to their FN-degrading capability. This capability may be catalyzed by uPA and/or metal-dependent serine proteinase-like proteases of 75 and 68 kDa.


Differential expression of the H-2Dk MHC class-I antigen and tissue inhibitor of metalloproteinases in metastatic and nonmetastatic T-10 fibrosarcoma cells. In previous studies, we have demonstrated that the highly metastatic IE-7 cell clone, derived from the T-10 fibrosarcoma, expressed both the H-2Dk and H-2Db genes, whereas a nonmetastatic IC-9 clone, derived from the same tumor, expressed only H-2Db, suggesting that the H-2Dk product might be involved in the metastatic phenotype. To substantiate this notion, IC-9 cells were transfected with an H-2Dk-expressing vector. Although all of the 4 randomly selected transfectant subclones elicited high H-2Dk expression, only one was as metastatic as IE-7 cells. This metastatic transfectant resembled IE-7 cells also in its inability to evoke CTL response in syngeneic mice, whereas the other transfectants were quite competent in this respect. It thus appears that the H-2Dk product may contribute to the metastatic phenotype provided that it is immunogenically abnormal. In addition, the present study provides evidence to suggest that lack of production of the tissue inhibitor of metalloproteinases TIMP-1/TIMP-2 is another important determinant in the metastatic phenotype of these cells.


Antimetastatic activity of boro-amino acid analog protease inhibitors against B16BL6 melanoma in vivo. Di- and tripeptide boro-amino acid analog protease inhibitors with specificity for chymotrypsin and elastase decrease the number of melanotic foci formed in the lungs of mice in the B16BL6 experimental metastatic tumor model. These effects were at significantly lower concentration than leupeptin or other natural chymotrypsin inhibitors previously reported. These results support the involvement of elastase and chymotrypsin in the metastatic process.


A cross-sectional and longitudinal study of craniomandibular dysfunction in an elderly population. Three cohorts of subjects in their 70s (born in 1901 to 1902, 1906 to 1907, and 1911 to 1912; n = 1,065) were investigated by means of questionnaires and clinical examination. The first cohort was followed to age 83 and the others to age 75. Symptoms of craniomandibular dysfunction were reported less frequently with increasing age. This was especially marked in men. Clinical signs of severe dysfunction were rare, and according to the Helkimo classification they tended to decrease with increasing age. The longitudinal results mainly confirmed the cross-sectional data. The results indicated that there is no increased risk of craniomandibular dysfunction with aging. On the contrary, awareness of such symptoms tended to decrease with aging.


Signs and symptoms of craniomandibular disorders in men with Reiter's disease. Fifty-two consecutive male patients with a medical diagnosis of Reiter's disease (RD) and 52 individually matched controls with no known general joint disease were examined for subjective symptoms and clinical signs of craniomandibular disorders (CMD) using routine stomatognathic methods. Patients with RD had more frequent and more severe subjective symptoms than did controls (P < .05). According to Helkimo's Clinical Dysfunction Index, subjects in the RD group had more severe clinical signs than those in the control group (P < .05). The most characteristic sign or symptom of CMD in the RD group was pain in the TMJ during function.


Prevalence of structural bony change in the mandibular condyle. Estimated on data derived from a longitudinal study of 172 orthodontic subjects, structural bony change in the mandibular condyle occurs in 5% of the individuals documented from childhood to adulthood. The first appearance generally was between 12 and 16 years of age. Differential diagnosis based upon signs and symptoms of CMD registered simultaneously, as proposed in the 1990 guidelines for craniomandibular disorders appeared to be inconsistent. To illustrate how suddenly the process of bony change may proceed, a case report is presented in which a severe change transpired within a 1-year interval in a 13-year-old patient.


Atypical odontalgia.

Atypical odontalgia. Atypical odontalgia describes atypical facial pain in apparently normal teeth. Unfortunately, dentists usually consider this diagnosis only after the failure of invasive treatment. Atypical odontalgia patients are typified by women in their mid-40s who complain of persistent pain in one or more premolar or molar teeth. They associate pain with dental procedures or trauma to the region. While the cause of atypical odontalgia is uncertain, deafferentation pain appears to be a plausible mechanism. This article reviews relevant aspects of this perplexing pain problem. To help avert the untimely diagnosis of atypical odontalgia, identifying inclusion criteria are presented.


Evaluation of masticatory function before and after treatment in patients with craniomandibular disorders. The masticatory function was evaluated in 12 patients with signs and symptoms of craniomandibular disorders of mainly muscular origin. Palpation of the masticatory muscles and measurements of occlusal force endurance, on a submaximal level with visual feedback, and of masticatory efficiency were performed before and after treatment. Significant changes occurred between the two measurements. Of a total of 10 masticatory muscles, 8 were sensitive to palpation before treatment and 2 after treatment. Occlusal force endurance increased from 92.5 seconds before treatment to 132 seconds after treatment, and masticatory efficiency increased from 54% to 65%, respectively. It is concluded that the masticatory muscle function of these patients is compromised and that treatment had a positive effect on the masticatory function.


A laboratory assessment of recording reliability and analysis of the K6 Diagnostic System. This laboratory study investigated the recording reliability and analysis of the K6 Diagnostic System, a computerized instrument that records mandibular movements in three planes. Two special devices were utilized for this purpose, one commercially available and the other designed and constructed by the authors. These devices could produce linear movements and simulate head and mandibular movements, respectively. The largest distortion of the simulated mandibular movements was found in the frontal plane tracings of simulated chewing patterns. For the linear movements in an x-axis, the error of the analyzed K6 system ranged from 9.4% to 30% and in a z-axis from 0% to 15%. A considerable degree of head movement was required to produce a significant error on the K6 measurements.


Radiographic signs of temporomandibular disorders to predict outcome of treatment. In 32 consecutive patients with temporomandibular disorders radiographic changes were correlated with the patients' assessment of treatment outcome. The patients had been referred for tomographic examination because the clinical signs and anamnestic data were inadequate for definite clinical diagnosis. Initially all patients were treated conservatively with a flat occlusal splint. Surgery was advised in appropriate cases. The subjective effect of treatment was assessed using a questionnaire, and the material was divided into responder and nonresponder groups. Seventy-eight percent (25) of the patients experienced a positive subjective response to the treatment. No radiographic sign was found to be statistically correlated to the outcome of treatment.


Effect of an anesthetic injected into the temporomandibular joint space in patients with TMD. Twenty-three adult female patients were studied before and after injection of one temporomandibular joint to relieve pain. These patients had exhibited a persistent history of pain within their mandibular, neck, and somatic muscles, despite repeated treatment involving occlusal splints, physical therapy, and biofeedback. Patients were also screened for possible condylar degeneration using corrected tomograms. Initially, patients rated their pain on a linear scale from 0 to 10 and designated the site of the pain on a full-body-profile chart. The presence and location of the pain was determined by manual palpation using a rating scale of 0 to 10, and by the patients designating those regions perceived as painful by marking a full-body-profile chart. After this initial screening, subjects received an injection of 1% lidocaine (1:100,000) to the upper intracapsular space of one joint. The pain profile chart was completed by the patients 15 minutes after injection. Twenty of the 23 patients demonstrated a significant decrease in pain located in facial, head, and neck regions. These data suggest that injection of a local anesthetic to the temporomandibular joint will decrease pain for a short time in ipsilateral and contralateral regions of the head and neck.


Chronic hemifacial pain caused by a tortuous facial artery: report of a case. An adult white female presented with a 22-year history of pain on the right side of her jaw. Digital palpation over the facial artery at the inferior border of the mandible elicited and exacerbated the pain. Surgical exploration revealed a coiled, tortuous facial artery. Removal of the aberrant artery provided complete pain relief.


[Band keratopathy. Symptomatological value based on 23 cases]. This study attempts to better define band keratopathy. A total of 23 eyes were reviewed, the largest sample ever published. The histopathology of this condition, characterized by lesions situated beneath the corneal epithelium, as well as its various clinical forms, are described. A distinction is drawn between band keratopathy and brown band keratopathy from an etiological and histological standpoint. The various available treatments are reviewed, emphasising lamellar keratoplasty as the safest and most effective technique.


[Surgery of retinal detachment of patients with pseudophakia using the panfunduscope]. Examination of the extreme periphery of the fundus of patients with pseudophakic retinal detachment is difficult due to poor pupil dilatation, optical aberrations from the intraocular lens, opacification of the posterior capsule or peripheral capsular remnants. Fifty-one patients with pseudophakic retinal detachment were operated on with using the wide angle panfunduscope of Rodenstock. It allows a very satisfactory pre- or intraoperative view of the extreme periphery of the fundus using the slit-lamp of the operative microscope combined with a scleral indentation. In only 3 cases no break was found in spite of pre- and intraoperative examination of the fundus periphery with the panfunduscope. Anatomic success was achieved in 47 out of 48 patients with a minimum of 6 months of follow-up; 3 patients were lost to follow-up. The mean postoperative visual acuity was 0.5. Unlike other methods of fundus examination, such the 3 mirror Goldmann lens or the indirect binocular ophthalmoscope, the panfunduscope allows good visualization of the peripheral retina of patients with pseudophakic retinal detachment using the slit-lamp of the operative microscope combined with a scleral indentation. Thus, small peripheral retinal breaks, often associated with pseudophakic retinal detachment, can be identified.


[Association of progressive external ophthalmoplegia and lattice corneal dystrophy]. The authors conducted a study in a family pedigree comprising 33 patients (men 16, women 17). In this pedigree there coexisted patients with progressive external ophthalmoplegia and corneal lattice dystrophy. Two patients with progressive external ophthalmoplegia and ten with lattice corneal dystrophy were found. One of our patients (propositus) suffered from both diseases. Our study proves that, in this pedigree, progressive external ophthalmoplegia and corneal lattice dystrophy have an autosomal dominant mode of inheritance.


[Post-varicella disciform keratitis].

[Post-varicella disciform keratitis]. Varicella disciform stromal keratitis is rare. It occurs several weeks or months after the skin rash. We report 4 cases in children, two of whom developed one or more recurrent episodes. Treatment based on local steroids was long and difficult to dose. One case treated with oral aciclovir did not show a better clinical course than the other patients.


[C2F6 in the treatment of retinal detachment associated to PVR: therapeutic trial]. We conducted a clinical trial on C2F6 as a retinal tamponade in the management of retinal detachment with proliferative vitreoretinopathy. Twenty seven eyes of 27 consecutive patients were enrolled in the study. Permanent retinal reattachment was achieved in 21 eyes (78%). The anatomic success rate was 85% in eyes with grade B PVR (17/20 eyes), and 57% in eyes with grade C and D PVR (4/7 eyes). The success rate was as high as that achieved in a previous series of eyes managed with the use of C3F8 combined with the same surgical technique. C2F6 shares the advantages of C3F8 in the management of retinal detachments complicated by proliferative vitreoretinopathy. However its absorption is more rapid as compared to C3F8. This is an advantage with regard to the postoperative disadvantages of gas tamponade. Further clinical use on a larger series of patients is required to confirmed the preliminary results.


[Orbital invasiveness of Merkel cell tumor of the eyelid]. A new case of neuroendocrine carcinoma (Merkel cell tumor) of the eyelid is reported. Local recurrence, spread to the orbit, led to exenteration and death of the patient. This trabecular carcinoma can be identified by histology, immuno-histochemistry and electron structural microscopy.


[Unilateral iris metastasis of cutaneous malignant melanoma]. We describe a case of cutaneous malignant melanoma metastatic to the iris and the angle 31 months after excision of the primary tumor in a 37-year-old caucasian female patient. The patient who had numerous metastases (lung, liver, cerebrum, skin) suffered from secondary glaucoma and died 5 months after the discovery of the intraocular metastases. The glaucoma was treated with medications and cyclocryotherapy. There was no response of the iris metastases to cyclical combined chemotherapy.


[A case of intraocular recurrence at a distant site of malignant melanoma of the choroid treated by cobalt 60 disk]. Twenty months after cobalt 60 plaque therapy of a choroidal malignant melanoma, a patient developed an intraocular recurrence at a site distant from and non contiguous to the original lesion that seemed controlled. The characteristics and the possible explanations of this unusual recurrence are discussed.


[Pigmented seborrheic wart on the skin of the eyelid]. Pigmented tumors of the eyelid are often difficult to identify accurately, as different tumors may have the same clinical presentation. We report the case of a 84 year old female patient who noticed a black tumor of the lower eyelid, with a recent increase in size. Clinically, this lesion was an exophytic tumor of the medial part of the left lower eyelid, respecting the lacrimal punctum and involving the palpebral margin. A surgical excision was performed. Microscopic examination revealed a pigmented seborrheic keratosis, a benign tumor of the epidermis. Histopathology has a key role in the precise diagnosis of pigmented tumors of the eyelid, in which the differential diagnosis concludes sweat gland cysts, pigmented basal cell carcinoma, naevus and uncommon malignant melanoma.


Surgical versus orthodontic correction of skeletal Class II malocclusion in adolescents: effects and indications. To clarify the effects of orthodontic versus surgical treatment and to distinguish more clearly those Class II patients who can be treated successfully with orthodontics alone, we compared three groups of adolescents: forty patients treated successfully with orthognathic surgery, 40 patients treated successfully with orthodontics alone, and 21 patients whose orthodontic treatment was judged to be unsuccessful. Successful surgical treatment was accomplished largely by bringing the mandible forward, but this involved vertically repositioning the maxilla, alone or in combination with advancing the mandible, in 40% of the patients. Successful orthodontic treatment resulted from a combination of retraction of the maxillary incisors and protraction of the mandibular incisors; most of the successfully treated group also had significant vertical growth, and 40% had greater than 2 mm anteroposterior growth. The unsuccessfully treated orthodontic patients initially had greater overjet, more severe mandibular deficiency, and greater anterior facial height than those treated successfully; they also had less retraction of the maxillary incisors and less growth during treatment. In Class II adolescents beyond the growth spurt, surgery is likely to be needed for successful correction of the malocclusion if the overjet is greater than 10 mm, especially if the distance from pogonion to nasion perpendicular is 18 mm or more, mandibular body length is less than 70 mm, or facial height is greater than 125 mm.


Recovery following orthognathic surgery and autologous blood transfusion. Patients undergoing maxillary surgery, with or without mandibular surgery, were divided into two groups. One surgeon's patients served as controls and did not receive blood unless hemodynamically indicated. The remaining surgeons' patients were transfused regardless of their hemoglobin levels following surgery. An attempt was made to identify benefits or complications associated with the reinfusion of autologous blood, particularly in patients with "low blood loss." Patients were asked to record when they returned to their presurgical level of activity. Of the 46 patients in the study 14 (12 nontransfused, two transfused) were not back to full activity 6 weeks after surgery. Of the 32 patients that reported a return to full activity within the study period, transfused patients reported a significantly quicker return to full activity at 2 weeks, 3 weeks, and 4 weeks postoperatively than did their nontransfused counterparts, even when blood loss at surgery was minimal. No complications have occurred with this practice.


The use of asymmetric yaw in the correction of lateral facial defects in hemifacial microsomia deformities: a case report. Treatment of a patient who had hemifacial microsomia and the long-term follow-up are presented. In selected cases, incorporation of an asymmetric yaw in orthognathic surgery can compensate for some of the soft tissue deficiency and asymmetry and produce esthetic results. Early surgical intervention is important to the success of treatment.


The use of osseointegration to stabilize a surgical elongation of the maxilla: a case report. Osseointegrated implants placed prior to maxillary downgrafting were utilized to stabilize the repositioned maxilla and interpositional bone graft. Eleven-month follow-up revealed complete healing of the 1.5-cm osteotomy gap and no maxillary relapse. Implant stabilization may be one solution to the relapse associated with inferior repositioning of the maxilla.


Prediction of ramus fragment relationship in the surgical correction of facial asymmetries. The Orthognathic Surgery Simulating Instrument is valuable for the presurgical evaluation of patients with dentofacial deformity asymmetry. The case report presents the use of the instrument in the presurgical workup of a patient with a severe facial asymmetry. Advantages over the use of a conventional articulator are also discussed.


Orthodontic finalization following therapy with an anterior repositioning splint. After phase I splint therapy for the management of posterior condylar displacement, it is not unusual to find that a posterior open bite has been created. Finalization of a new occlusal position may be effected via occlusal equilibration, prosthodontics, orthodontics, orthognathic surgery, or a combination of these procedures. Stabilizing the occlusion with orthodontics in the new orthopedic jaw position requires a systemic approach. This article outlines a strategy for orthodontic finalization in phase II therapy. The splint-guided position is maintained while intra-arch and interarch malocclusions are corrected. The objective in treatment of posterior condylar displacement via splint therapy and orthodontics lies in the provision of a sound condylar position and the movement of the teeth and mandible into a stable and esthetic position.


Stability of transient, semirigid pin fixation of sagittal split mandibular osteotomies. Cephalometric records of 16 patients who underwent mandibular lengthening, stabilized with noncompressive pin fixation, were examined retrospectively. Digitization and computer analyses of the cephalometric changes for various time intervals were performed. All linear changes were stable for 13 of the 16 patients over the follow-up period of 2 years. No significant correlation was found between postoperative horizontal relapse and amount of advancement. A high degree of postfixation stability was obtained with very short fixation periods. While further study of this pin fixation technique is indicated, these preliminary results are favorable.


Catalase/peroxidase activity in dental pulp. Extrinsic stains on vital teeth are bleached with 30% hydrogen peroxide (H2O2) or carbamide peroxide, H2O2 greatly inhibits the activity of several enzymes. Free H2O2 and carbamide peroxide readily enter the pulp through the coronal wall of the tooth. Nevertheless, adverse effects have been remarkably rare. This study was undertaken to determine whether dental pulp exhibits any catalase or peroxidase activity that might protect it from damage during vital bleaching procedures. Pulpal tissue from healthy human teeth was assayed for catalase and glutathione peroxidase activity. A phosphate buffer extract of the tissue served as the source of the enzymes. The rate of breakdown of H2O2 by the tissue extract was measured and the rate constant for catalase was determined. The catalase activity, defined as microM H2O2 broken down/min/mg wet tissue, was determined and found to be only 2 x 10(-2), which is very low. The fibrous pulpal tissue was found to exhibit virtually no glutathione peroxidase activity.


Histomorphometric comparison of canals prepared by four techniques. Numerous methods of root canal preparation have been recommended and used by clinicians. This study used histomorphometrics to determine the area of root canal preparations using four currently popular techniques. Clinicians that were highly skilled in each technique prepared curved canals in acrylic blocks. Each clinician described this technique and discussed the technique with regard to the use of acrylic blocks as compared with dentin. Analysis of the areas of the root canals after preparation revealed a significant difference among the groups. The mean areas after treatment were step-back technique, 17.33 mm2; Cavi-Endo technique, 15.87 mm2; Canal Master technique, 13.56 mm2; and balanced force technique, 17.31 mm2. Photographs of the blocks used in the study were included for inspection by the reader.


Apical dye penetration with four root canal sealers and gutta-percha using longitudinal sectioning. The purpose of this study was to compare the level of apical dye penetration when different sealers were used with lateral condensation of gutta-percha. Fifty teeth with single root canals were biomechanically prepared using the step-back technique and irrigation with 15% ethylenediaminetetraacetic acid with cetrimide and 1% NaOCl solutions. The teeth were divided into five groups of 10 teeth each. The control group root canals were filled with laterally condensed gutta-percha without sealer and the other four groups were filled with laterally condensed gutta-percha and either Apexit, Sealapex, Tubli-Seal, or AH-26 sealer. After storage in 100% humidity at 37 degrees C for 48 h, the root surfaces were coated with nail varnish (except at the apex), placed in 2% methylene blue dye solution, and centrifuged at 30 x g for 3 min. The roots were sectioned longitudinally to determine the following mean levels of dye penetration: AH-26, 0.48 mm; Apexit, 1.33 mm; Sealapex, 4.59 mm; Tubli-Seal, 5.58 mm; and gutta-percha alone, 7.99 mm. This study demonstrated that a root canal sealer should be used in conjunction with laterally condensed gutta-percha and that AH-26 sealer had significantly less dye penetration than the other three sealers while Apexit had significantly less dye penetration than Sealapex and Tubli-Seal. There was no significant difference between Sealapex and Tubli-Seal.


A comparison of intracanal stresses in a post-restored tooth utilizing the finite element method. The finite element method was used to compare stresses along the inner canal wall in four two-dimensional models of an average maxillary central incisor. The four models evaluated were an intact incisor, an endodontically treated incisor, an endodontically treated crown-restored incisor, and a cylindrical post and crown-restored incisor. A horizontal static force, 1 Newton in magnitude, was applied to the lingual surface of each model and the maximum tensile, compressive, and shear stresses were calculated using the general purpose finite element program PAFEC 75. Results indicate that the stress patterns within the root are altered as a result of post insertion. Specifically, the maximum bending stresses are associated with the apical termination of the post, and post placement does not result in a uniform distribution of stress along the canal wall.


Thickness of cementum/dentin in mesial roots of mandibular first molars. The mesial roots of 15 human first lower molars, along with the corresponding half of the tooth crown, were studied to determine the thickness of dentin-cementum. A device was developed whereby these could be embedded in resin with a precisely known orientation in space. The roots were radiographed in mesiodistal and vestibular-lingual projections, then sectioned perpendicular to the canal axis in the coronal third. Thickness of dentin-cementum was compared on sections and radiograms; results showed that the amount of hard tissue is effectively about one fifth less than that appearing on the radiogram.


An in vivo evaluation of the efficacy of ultrasound after step-back preparation in mandibular molars. This study histologically compared the in vivo debridement efficacy of the step-back preparation versus a step-back/ultrasound preparation in the mesial root canals of vital mandibular molars. Group 1 consisted of 17 teeth prepared with a step-back technique using intermittent irrigation with 5.25% sodium hypochlorite. Group 2 consisted of 17 teeth prepared with a step-back technique as in group 1 followed by 3 min of ultrasonic instrumentation per canal utilizing a #15 Endosonic file in an Enac unit set at 3.5. An additional 6 ml/canal of 5.25% sodium hypochlorite was used during the ultrasonic preparation. Eight uninstrumented mandibular molars served as histological controls. Following extraction and histological preparation, 0.2-microns cross-sections from the 1- to 3-mm apical levels of the canal and isthmus were evaluated for percentage of tissue removal using an Olympus CUE-2 Image Analysis System. Factorial analysis of variance indicated canal and isthmus cleanliness values were significantly higher, at all 11 apical levels, with the ultrasonic technique. Sample values at the 1-, 2-, and 3-mm levels for the step-back and step-back/ultrasonic techniques, respectively, were: canal, 64% versus 92%, 81% versus 97%, and 90% versus 99.9%; isthmus, 2% versus 46%, 15% versus 60%, and 16% versus 83%.


The relationship between clinical symptoms and anaerobic bacteria from infected root canals. The purpose of this study was to investigate the correlation between the composition of bacterial flora from infected root canals and clinical symptoms. The materials evaluated consisted of 28 teeth from 25 patients with apical periodontitis. Eubacterium were found to be significantly related to acute or chronic clinical symptoms and Peptococcus, Peptostreptococcus, and Porphyromonas gingivalis to subacute clinical symptoms. We suggested that Peptococcus, Peptostreptococcus, Eubacterium, Porphyromonas, and Bacteroides were significantly related to percussion pain; Porphyromonas and Bacteroides were significantly related to odor in the infected root canals. Many Bacteroides were isolated from most of the infected root canals.


Root canal morphology of mandibular incisors. In this study, 100 mandibular central and lateral incisors were used to determine the number of root canals and their types, the ramifications of the root canal, the location of apical foramina, and the frequency of apical deltas. The teeth were immersed in India ink, decalcified, and cleared. The examination of root canal systems of the teeth was based on Vertucci's classification. Two more root canal types which are not defined in that classification have also been determined and grouped as new types.


Endodontic retreatment: a rational approach to root canal reinstrumentation. During nonsurgical endodontic retreatment, endodontic instruments are forced apically to remove the root canal filling material and regain canal patency. Undiscriminating burrowing down the canal in the apical direction may be fruitless and harmful. To avoid complications, the dentin overhanging the canal orifice must be removed and an unobstructed access established to the root filling material, so as to facilitate its removal. Reinstrumentation of the filled canal must take into consideration the nature of the filling material and the physical properties of endodontic instruments, as well as the dynamic aspects of canal preparation. This article discusses the mechanical considerations pertaining to root canal retreatment and outlines a step by step rationale approach to retreatment.


Effect of moisture and aging on gutta-percha. The purpose of this article was to study the plasticizing effect of controlled levels of different humidities on native and commercial gutta-percha samples. It was expected that the results might provide the practicing endodontist with invaluable insight into the mechanical properties of commercial gutta-percha cones (i.e. retrievability, malleability, flexibility, torsional, and bending ability). The "conditioning" of the gutta-percha samples depended greatly on the percentage of compatible and incompatible substances. Mixtures of native gutta-percha with compatible substances (e.g. wax) showed greater elongation, tensile strength, and number of rotations but lower deformation angle than mixtures of native gutta-percha with incompatible substances (e.g. salts, metal oxides). The observed lower values for tensile strength and torsional strain and higher value for elongation and number of rotations for wet samples compared with the dry ones were attributed to the plasticizing effect on gutta-percha of the insertions of water molecules in the polymer chains.


Delineation of cytotoxic concentrations of two dentin bonding agents in vitro. Until adhesiveness of dentin bonding agents and other restorative materials to dental structures can be assured, microleakage into resulting "gaps" and dentin permeability will remain major concerns in cases of pulpal irritation. The objectives of the present study were to (a) delineate the kinds and levels of metabolic cytotoxicity of the GLUMA and Scotchbond 2 systems as well as glutaraldehyde and 2-hydroxyethylmethacrylate, and (b) compare the effects of these same materials after diffusion through dentin discs approximately 0.5-mm thick. In monolayer cultures, glutaraldehyde was much more cytotoxic than 2-hydroxyethylmethacrylate. However, GLUMA sealer and Scotchbond 2 adhesive exhibited similar cytotoxicity in monolayer cultures. After diffusion through dentin, glutaraldehyde and 2-hydroxyethylmethacrylate effects were diluted 14.7 and 26.7 times, respectively. The postdiffusional effects of the GLUMA and Scotchbond 2 systems were not significantly different and less than those effects in monolayer cultures. This study should help in the evaluation of possible causes of pulpal irritation following restorative procedures.


Dentin removal efficiency of six endodontic systems: a quantitative comparison. The dentin removal efficiency of current endodontic systems, based on the amount of dentin removed in 1 mm of canal axial length, was determined for working times of 1 and 2 min. Six endodontic systems were compared: The Giromatic with Heli-Giro files, the Sonic-Air with Shapers, the Mecasonic with Shapers, the Cavi-Med with K files, the Cavi-Med with Shapers, the Excalibur with its own K files. Generally speaking, the efficiency of each device depends on the duration of instrumentation, on the type of file used, and on its mode of activation. For 1 min of instrumentation, the Mecasonic+Shaper was the most efficient system. For 2 min of instrumentation, the original adaptation of the Shaper on the Cavi-Med gave the highest activity. Concerning the files used in ultrasonics, the Shaper seems to be more efficient than the K file. As for the sonics, the Excalibur+file system gave results comparable to those of the Mecasonic+Shaper; both of these devices were twice as efficient as the Sonic-Air+Shaper.


Efficacy of several concentrations of sodium hypochlorite for root canal irrigation. Sodium hypochlorite (NaOCl) has been recommended for irrigation during root canal preparation. This investigation used scanning electron microscopy to examine instrumented and uninstrumented surfaces in the middle third of root canals following the use of several concentrations of NaOCl (5.25%, 2.5%, 1.0%, and 0.5%). NaOCl was delivered with either an endodontic irrigation needle or an ultrasonic device. All of the concentrations of NaOCl with either delivery system were very effective in flushing out loose debris from the root canals. A smear layer with some exposed dentinal tubules was seen on all instrumented surfaces regardless of concentration of NaOCl or irrigation device. NaOCl in concentrations of 5.25%, 2.5%, and 1% completely removed pulpal remnants and predentin from the uninstrumented surfaces. Although 0.5% NaOCl removed the majority of pulpal remnants and predentin from the uninstrumented surfaces, it left some fibrils on the surface.


Microleakage comparison of apical seal of plastic versus metal Thermafil root canal obturators. This study compared the apical seal of plastic versus metal Thermafil obturators in extracted human teeth. The obturated teeth were evaluated radiographically for the extent and adaptation of the filling obturator. No difference was seen between plastic and metal for over- or underfilling. Voids were seen more often in smaller sizes of both plastic and metal obturators. Obturated teeth were stained in India ink, decalcified, and cleared. Microleakage evaluation of the transparent teeth showed no statistical difference between metal and plastic obturators.


Effect of precurving endosonic files on the amount of debris and smear layer remaining in curved root canals. Endosonic files are prone to constraint; this reduces their efficiency, particularly in the apical third and in curved root canals. Precurving the file may reduce constraint, thereby improving the file's ability to debride. This investigation was undertaken to compare both straight and precurved endosonic files as to debris and smear layer removal. Thirty-six curved root canals were randomly allocated into six groups. Each group was prepared using a step-down technique, then instrumented with either a straight or precurved endosonic file of size 15, 20, or 25. The tooth roots were split and examined under the scanning electron microscope. Blind examinations were made for debris and smear layer removal and evaluation scores were analyzed using a log linear approach. The root canals instrumented with the precurved files had a significantly lower debris score than those prepared with straight files. Precurving did not affect smear layer removal. In conclusion, precurving of files decreased the amount of debris but did not affect smear layer removal.


Characterization of total membrane protein of Porphyromonas endodontalis. Porphyromonas endodontalis strains ATCC 35406, HG 181, and HG 413 were cultured in an enriched broth medium, and growth curves were determined. Total membrane protein profiles of cells, harvested either from exponential phase or from stationary phase of growth, were studied by sodium dodecyl sulfate polyacrylamide-gel electrophoresis. The protein profiles indicated that the three strains shared three major proteins, designated A, B, and C, with molecular masses of 59, 43, and 41 kDa, respectively. In addition, the strains showed homology among the majority of the minor proteins. However, some minor proteins were unique for each strain. Two common minor proteins with molecular masses of 56 and 51 kDa were weakly expressed or absent in membrane preparations from cells of the early exponential phase, while they were present in membrane preparations from cells harvested in the late phase of growth. The major and minor membrane proteins may play a role in the interaction between P. endodontalis and the host. In addition, the membrane proteins may play an important role in the physiology of this endodontic pathogen.


Factors associated with endodontic treatment failures. Two hundred and thirty-six cases of endodontic treatment failures, none of which had advanced periodontal disease, postperforations, or root or crown fractures were analyzed clinically, radiographically, and histobacteriologically to determine the major factor(s) for treatment failures. It was found that there was a correlation between bacterial infection in the canal system and the presence of periradicular rarefaction in endodontic failures. This report provides evidence indicating that the major factors associated with endodontic failures are the persistence of bacterial infection in the canal space and/or the periradicular area and the presence of preoperative periradicular rarefaction. The apical extent of root canal fillings, i.e. underfilled, flush-filled, or overfilled, seems to have no correlation to treatment failures.


Endodontic treatment of fused teeth.

Endodontic treatment of fused teeth. A case is reported documenting successful treatment of suppurative periradicular periodontitis involving a maxillary central incisor fused with a supernumerary tooth. Endodontic therapy was performed and partial resolution of the lesion was evident at the 1-yr recall and further resolution at the 16-month recall.


Employment and utilization of dental hygienists in Minnesota healthcare facilities. This study surveyed a representative sample from the entire listing of accredited hospitals and licensed nursing homes in Minnesota with bed accommodations of 100 or more. The purpose of the study was to determine (1) the current providers of oral healthcare to patients/residents in the selected facilities; (2) the employment and utilization of dental hygienists in these facilities; and (3) reasons for not employing a dental hygienist. A questionnaire was designed and sent to 147 facilities in November 1986 with a follow-up in January 1987. A total of 118 questionnaires were returned, resulting in a response rate of 80.3%. The results revealed that less than half of the facilities utilized a dental hygienist. In the majority of facilities surveyed, consulting dentists, registered nurses, licensed practical nurses, and nurse's aides were identified as those responsible for providing oral healthcare services. Insufficient funds was the primary reason identified by these facilities for not employing a dental hygienist. Dental hygienists employed in healthcare facilities provided therapeutic treatment and oral hygiene education services to staff and patients. In comparison, visiting dental hygienists tended to perform more staff training than patient education or therapeutic services. Most respondents indicated that a dental hygienist employed by their facility would improve the oral health status of their patients or residents. A large number of respondents appeared to be uncertain of the role of a dental hygienist in their healthcare facilities. Educational efforts are needed to increase the understanding of healthcare administrators and the public of the benefits of employing dental hygienists.


The use of lasers in implantology: an overview. While lasers have been utilized in oral surgery for many years, the recent advent of improved delivery systems together with a range of laser wavelengths from which to choose has promoted interest in the application of lasers in other areas within dentistry. This paper provides an overview of the use of lasers in laboratory and clinical techniques used in implantology, with particular reference to carbon dioxide, Nd:YAG, argon, and erbium:YAG lasers. From a consideration of how particular laser wavelengths interact with metallic and ceramic implant materials, and with bone and soft tissues, principles for the rational and safe use of lasers are deduced.


Load transfer from endosteal implants to supporting bone: an analysis using statics. Part one: Horizontal loading. By use of engineering statics, the amount of force transferred to the crestal bone from a horizontal occlusal load, relative to the implant length necessary to support that load, was analyzed for hypothetical instances when the implant was embedded in a uniform mass of bone and when it was bicorticated. The analysis revealed that implants longer than 12 mm will not significantly reduce force transfer proportionately to the increased length. Also, bicortication will mitigate force transfer to the crestal bone. Finally, the amount of force transfer is directly proportional to the height of load application from the crestal bone.


Load transfer from endosteal implants to supporting bone: an analysis using statics. Part two: Axial loading. Engineering statics was used for the analysis of axial occlusal load transfer by a dental implant to the supporting bone. The analysis revealed that an implant can be totally supported by trabecular bone. Also, an implant of only 10 mm in length with a 4-mm diameter can transmit average maximum biting forces to the supporting bone within the physiologic strain limits of the bone.


Torsional stability of HA-coated and grit-blasted titanium dental implants. Hydroxylapatite (HA)-coated and grit-blasted (non-HA-coated) titanium dental implants were inserted into healed extraction sites of canine mandibles. After six weeks, the animals were killed and the implants mechanically tested in torsion to failure. Interface attachment strength, implant/tissue compatibility, integrity of the HA coating, and the location of interface failure were evaluated. Mechanical testing demonstrated an interface torsional strength of 3.98 +/- 0.93 MPa for the HA-coated implants and 2.25 +/- 0.65 MPa for the grit-blasted implants. This represents a 76.9% improvement in the maximum torsional interface strength, and is statistically-significant (p = 0.0004). On qualitative histologic analysis, interface failure was seen to occur primarily at the HA/implant interface, although failure through the HA coating and regions of bone/HA interface failure were observed. The HA-coated implants had bone in direct apposition to their surface with no fibrous tissue interposition. The grit-blasted implants also had regions of direct bone-implant apposition, but these areas were limited to a smaller proportion of the total interface area. There was no evidence of breakdown or change in thickness of the HA coating.


A comparison of femoral and mandibular animal models for the evaluation of HA-coated implants. The application of hydroxylapatite coatings promises marked improvement in the rapidity and durability of osseointegration for both dental and orthopedic metallic implants. Standard methods for the in vivo assessment of the performance of experimental implants include canine mandibular and femoral transcortical implantations. This study compared the results of the two procedures by use of similar HA-coated titanium implants. The results indicate that the rapidity of osseointegration and the maximum attachment strength for mandibular dental implants approximate those of the femoral transcortical implants, especially at longer post-operative intervals. We conclude that the two models are comparable for the purpose of evaluating the performance of this type of implant and can be used interchangeably by dental and orthopedic implant designers. HA-coating of titanium implants provides extensive osseointegration in both mandibular and long-bone models, with similar mechanical attachment strengths and histologic appearance.


The use of a new form of allograft bone in implantation or osseointegrated dental implants--a preliminary report. The use of and early results with a new form of demineralized allograft bone tissue with the immediate placement of a dental implant are described. No occlusive membranes were utilized. GRAFTON Allogeneic Bone Matrix (ABM) is processed from human cortical bone into a thick gel consistency and packaged sterile in disposable syringes. The material was utilized in seven patients with seven implants. New bone formation was noted and, with the exception of two implants with a small amount of thread exposure, complete. It appears that treatment with the bone-grafting material produced clinical results similar to those reported with the use of barrier membranes and may provide an alternative to guided tissue regeneration. Further investigation appears warranted.


Simulated implant surgery in rabbit long bones: a descriptive study. The objectives of this study were: (a) to observe and describe the variability of bone healing in implant receptor sites which were prepared in rabbit femurs by use of different surgical methods; and (b) to determine if the animal model which was used was suitable for the detection of differences in healing reactions in implant receptor sites which were prepared by different surgical methods. Three 3-mm-wide implant receptor sites were prepared in the right and left femurs of four large New Zealand white rabbits. The surgical parameters used in preparation of the different sites included: low speed with no irrigation (LSO); low speed with internal irrigation only (LSI); low speed with external irrigation only (LSE); high speed with no irrigation (HSO); or high speed with external irrigation only (HSE). The sites were randomized so that each animal had one of each type of site in either the right or left femur. A non-treated control site was located in each animal for comparison with experimental sites. The animals were killed at 7, 14, 21, and 28 days post-operatively. The resultant samples were fixed, embedded, sectioned, and stained with basic fuchsin and toluidine blue. The results indicated that this was probably not a suitable animal model, since no discernible differences were detected in the various healed sites.


A study of osteoporosis as it relates to metabolic manifestations in edentulous women. Among some patients, regardless of age, the jaw loses bone mass, leading to loosening and falling out of otherwise healthy teeth. This study seeks to establish whether this bone loss is associated with the metabolic manifestations of other forms of localized decalcifications, such as in Paget's disease, or with generalized osteoporosis. Sixteen women being fitted with dental implants to compensate for bone losses provided 24-hour urine samples for the quantitative determination of calcium and galactosyl hydroxylysine, a bone collagen metabolite. These patients provided demographic information, relevant medical, dental, and dietary history, a profile of their current medications, and the status of their smoking and exercise habits. Urinary excretion of galactosyl hydroxylysine, which is increased in the presence of progressive increased bone resorption, remained within normal values in the patients of this study. These results suggest that the thinning of the jaw bones and subsequent tooth loss of these subjects were osteoporotic processes too limited and too localized to produce measurable increases in urinary bone metabolites.


The position and course of the mandibular canal. Twenty-nine human cadaver mandibles were dissected longitudinally and cross-sectionally for determination of the precise location of the inferior alveolar nerve, artery, and vein. The neurovascular bundle was located in contact with, or very close to, the lingual cortical plate until it reached the mental foramen. Anterior to the mental foramen, the neurovascular bundle was not a distinct entity and was located close to the labial cortical plate. In the body of the mandible, the neurovascular bundle was located about one centimeter above the mandibular inferior border. The distance from the lateral border of the neurovascular bundle to the external surface of the buccal plate was usually half a centimeter in the molar and premolar regions. The mandibular canal was usually formed by a thin bony plate that, grossly, had more of an appearance of trabecular bone; in only a few mandibles was there a thin layer of cortical bone.


Spark erosion fixed/detachable prosthesis for the completely edentulous maxilla. A technique is described for restoration of the completely edentulous maxilla. From six to eight root-form implants are surgically placed in the edentulous maxilla. A hybrid overdenture is constructed by use of a two-degree tapered precision milled primary bar. A cast overdenture prosthesis is constructed over this bar, and precision attachments are spark-erosion-processed to the primary and secondary prosthetic components. The technology described in this article allows for an intimate fit of the various prosthetic components. This prosthetic protocol permits maximum retention and stability of the prosthesis and solves many problems which are encountered in the oral rehabilitation of the edentulous maxilla.


Bone regeneration and tissue acceptance of human fascia lata grafts adjacent to dental implants: a preliminary case report. The biologic principle of guided tissue regeneration (GTR) has been studied extensively in hopes of regenerating alveolar bone. Various materials have been utilized as regenerative membranes; however, all materials have disadvantages, and the ideal membrane material is yet to be identified. In this case report, human freeze-dried fascia lata strips were used as a regenerative barrier membrane in conjunction with the placement of endosseous root implants and demineralized, freeze-dried bone allograft. The major advantage in the use of human fascia lata for guided tissue regeneration is that a second procedure to remove the material is not necessary, and the fascia is accepted by the surrounding tissues without complication. There is acceptance of four endosseous root-form dental implants that were immediately placed into fresh extraction sockets and covered with demineralized freeze-dried bone allograft (DFDBA), with human freeze-dried fascia lata used to serve as a biocompatible, collagenous, regenerative augmentation membrane over the dental implants. The biologic concept of GTR is clinically applied to increase the dimensions of the edentulous, maxillary alveolar ridge with use of human freeze-dried fascia lata barrier membranes.


[Emergency medical aid to patients with craniocerebral trauma in the prehospital period]. On the basis of analysis of more than 5000 observations of the sufferers admitted to the Kiev Research Institute of Neurosurgery for acute craniocerebral trauma from 1975 to 1991, quality of giving medical aid at the prehospital period was studied. Of most importance, are the measures directed at struggle against respiratory disorders, disturbances in cardio-vascular activity, shock, hemorrhage.


[Prevention and treatment of purulent inflammatory complications of open craniocerebral trauma with decamethoxine ]. In the work based on the analysis of observation of 154 sufferers with an open craniocerebral trauma, the positive therapeutic and preventive action of agueous solutions of decamethoxine is shown.


[Hyperbaric oxygenation in the comprehensive therapy of young and middle age patients in the acute period after mild craniocerebral trauma]. The results of treatment of 107 young and middle aged sufferers with mild craniocerebral trauma have been analysed. The regimen for use of hyperbaric oxygenation contributing to normalization of general cerebral, focal disorders in high nervous and psychic activity, prevention of certain posttraumatic complications has been developed.


[Cerebrospinal fluid sorption in the treatment of severe craniocerebral trauma in the acute period]. The effectiveness of the use of liquorosorption in treatment of 6 sufferers with severe craniocerebral trauma is shown.


[Predictive value of the combined electro-, echo-, and rheoencephalographic studies in the acute period after severe craniocerebral trauma complicated by intracranial hemorrhage]. On the basis of the data of complex studies, the signs of changes in the bioelectrical activity of the brain, state of its middle structures and hemodynamics in favourable and lethal outcome of craniocerebral trauma complication by intracranial hemorrhage have been established. Early detection of the signs mentioned contributed to improvement in the results of treatment at the acute period.


[Correction of lipid peroxidation disorders of patients in the acute period after craniocerebral trauma]. In sufferers at the acute period of mild and severe craniocerebral trauma, the processes of peroxide oxidation of lipids become essentially more active. The antioxidative function of an organism decreases. Changes in the metabolic processes are the most pronounced in patients under 44 years and in women of different age in severe craniocerebral trauma. The authors recommend to include into the complex of treatment in craniocerebral trauma the intensive antioxidant therapy together with surgical intervention.


[Brain concussion in patients with chronic vascular, gastrointestinal and pulmonary diseases]. Examined were 317 patients with brain concussion ranging in age from 16 to 75 years. Of them in 133 (41.91%), chronic diseases (I-II degree chronic insufficiency of cerebral circulation, arterial hypertension, chronic cholecystitis, gastric and duodenal ulcer disease, chronic bronchitis, bronchial asthma) were revealed. Peculiarities of the course of brain concussion in these patients are noted. The author stresses that it is necessary to take into account chronic diseases when observing and treating the sufferers with brain concussion.


[Plastic reconstruction fo cranial vault defects]. Peculiarities of performance of the reconstructive operation performed in 350 patients at primary surgical treatment, or later on, at the period of primary treatment of a patient at a hospital and at his readmission with the aim of cranioplasty are considered. The authors recommend to perform the reconstructive operation in presence of a cranial vault defect at the time of primary surgical treatment, or 2-5 weeks later, when preparing a patient for such an operation.


[Specifics of diagnostic and surgical approach in the treatment of complicated injuries of the extremities in the acute period]. The results of treatment of 82 patients with associated injury to the nerves of the extremities have been analysed. In rupture of a nerve, the clinico-neurologic examination has the most informative value, in its partial injury, the performance of electrophysiologic investigations is mandatory. A degree of restoration of the extremity function depends on timeliness and adequacy of the operation.


[Intensification of surgical therapy of traumatic injury to the median and ulnar nerves in the acute period]. The results of experimental development of the use of Quercitrol, the inhibitor of leukotrienes, and helium-neon laser acupuncture for the treatment of antiinflammatory operative neuroma decelerating the process of neural tissue regeneration are presented. The positive data of the experiments have been confirmed in the clinic.


[Clinico-morphologic evaluation of susceptibility of glioblastoma to antiblastic therapy]. Pathomorphology of a cerebral glioblastoma in 82 patients was studied. The most pronounced regressive changes in the glioblastoma occurred under the influence of a complex of antiblastic treatment, including polychemo- and immunotherapy, radiation therapy. A high degree of damaging effect on a glioblastoma tissue correlated with the longest lifetime of the patients--(22.8 +/- 2.6) mos. Of these patients, 26% survived more than 24 mos, 17%--more than 36 mos. In patients with chemo-resistant glioblastoma which retains morphologically a stability of its histologic structure, the mean survival almost didn't differ from that in the control group. Only few patients survived more than 1 year.


[Acute disorders of adrenal function in supratentorial meningioma]. Of the 128 patients operated on for meningioma of supratentorial location in 52 (23.9%), hemorrhage into the adrenal tissue was revealed. Clinical diagnosis of this pathology is difficult. Pathogenetically, hemorrhage into the adrenal tissue should be considered as manifestation of generalized vascular disorders in complicated postoperative course, which are associated with significant functional strain of the endocrine system resulting from stress reactions.


[Clinico-diagnostic value of the immunologic parameters of blood and cerebrospinal fluid in patients with a tumor of the posterior cranial fossa]. In 37 patients with a tumor of the posterior cranial fossa, the immunologic indices of the spinal fluid, blood serum and tumor contents were studied. It was established that changes in the immunologic indices (intrathecal synthesis of IgG and IgA, production of the immunoregulatory factors of cellular immunity, severity of lesion of the brain structures) depended on a degree of tumor anaplasia and age of the patients. These findings can be used for diagnosis of cerebral neoplasms of different degree of malignancy with regard for the age of a patient.


[Surgical treatment of nodular goiter after the accident at the Chernobyl nuclear power station]. The data on incidence of goiter in inhabitants of Kiev province for 5 years after Chernobyl accident, increase in number of operations performed for nodular forms of autoimmune thyroiditis and thyroid cancer are presented.


[Experience with surgical treatment of endemic and diffuse toxic goiter]. The results of operative treatment of 1336 patients operated on for goiter are presented. In presence of nodules in the thyroid gland, subtotal resection of a lobe, or the lobes of the gland was performed, in suspected malignant tumor--its extirpation.


[Prevention of acute purulent inflammatory diseases of the fingers and hand with decamethoxine]. Resulting from disease-prevention work among population of the district, use of BF-6D glue for treatment of microtraumas to skin of the hands, the number of patients with inflammatory diseases reduced by 14.7%.


[Indications and technique of conservative surgery in renal cancer]. The organ-preserving surgical intervention for renal cancer was performed in 42 patients. Five-year survival was 64.4%.


[One-stage operations in bilateral nephrolithiasis]. The results of treatment of 60 patients with bilateral nephrolithiasis undergoing one-stage operations are presented.


[Effectiveness of combined spinal anesthesia]. Combined spinal anesthesia with the use of hyperbaric solution of lignocaine at an average dose of (69.4 +/- 1.4) mg and morphine hydrochloride at a dose of 0.3 mg was used in 50 patients with II-IV degree anesthesiologic risk during one-stage appendectomy. Effective intraoperative anesthesia was achieved in (96.2 +/- 2.5) % of cases. Duration of postoperative analgesia was (26.8 +/- 1.1) h. Suppression of breathing, hyperalgesia on termination of the effect of a local anesthetic were not noted. In (50.1 +/- 1.7) % of the patients, intraoperative hypotension was revealed. After the operation, nausea was noted in (20 +/- 11.5) % of these patients, vomiting--in (6.0 +/- 2.3) %, itch at the site of puncture--in (22.0 +/- 10.4) %, shiver--in (2.0 +/- 1.4) %.


[Early diagnosis of acute postoperative hepatic insufficiency in surgical patients]. An original method for diagnosis of hepatic failure at the early postoperative period is described. Diagnosis of hepatic failure was confirmed in 98% of patients, in 2%, the diagnosis has proved to be uncertain.


[Therapeutic preventive measures for protection of spinal marrow in the acute period after vertebro-spinal trauma]. In accordance with the pathophysiological changes in the spinal cord in trauma, the authors recommend to pay the main attention to normalization of an anatomo-morphological disorders, prevention of biochemical shifts and restoration of hormonal background. The scheme suggested should be assumed as a basis for tactics of treatment of the sufferers with a vertebro-spinal trauma.


[Pulse-leukocytic-temperature index of intoxication]. The expediency to use for assessment of the severity of organism intoxication a pulse-leukocytic-temperature index of intoxication, which takes into account the leukocytic index of intoxication, body temperature, pulse, is showa.


[Principles of emergency aid in craniocervical trauma of divers]. On the basis of analysis of 113 cases, peculiarities of giving emergency aid to the sufferers with craniocervical trauma in divers were studied.


Purification and characterization of an immunodominant 36 kDa antigen present on the cell surface of Clostridium difficile. The 36 kDa antigen represents the major EDTA-extracted protein of Clostridium difficile strains belonging to electrophoretic group 2. Antibodies to this antigen are found in sera of patients with C. difficile-associated diarrhoea. The 36 kDa antigen was extracted from C. difficile C253 by EDTA and purified by gel filtration (Sephacryl S300) and ion exchange chromatography (DEAE-Trisacryl M). The molecular weight of the purified protein was 36 kDa as determined by SDS-PAGE, also in non-reducing conditions. By gel filtration, the molecular size appeared to be 72 kDa and was not modified by the presence of EDTA or SDS in the column buffer. Since IEF showed a single isoelectric form of pI 4.6, the protein could be a homodimeric molecule. Immunofluorescence demonstrated that the 36 kDa antigen was located on the surface of the C. difficile cell. Monospecific antiserum raised in rabbits reacted positively with the 36 kDa protein of most group 2 C. difficile strains isolated from antibiotic-associated diarrhoea (AAD) outbreaks in Italy and other European countries.


The virulence plasmid does not contribute to growth of Salmonella in cultured murine macrophages. The virulence plasmid, characteristic of many serovars of Salmonella sp., and specifically its spv genes, promote intracellular growth of the bacteria in the liver and spleen and are essential for the virulence of these Salmonella serovars in the mouse. In an attempt to establish an in vitro model for studying its function, we evaluated its effect on the intracellular growth of the bacteria in macrophages in culture. We used a number of different macrophage-like cell lines (J774-A.1, IC-21 and PU5-1.8), as well as peritoneal or splenic macrophages from genetically Salmonella-sensitive (Itys, BALB/c) or resistant (Ityr, C3H/HeN) mice, and at different states of activation, stimulated in vivo or in vitro with lipopolysaccharide and/or recombinant gamma interferon. These were found to differ in their ability to suppress or sustain intracellular growth of several Salmonella serovars, but in all cases the growth was independent of the spv genes.


Changes in the structure of the cell surface carbohydrates of the chinchilla tubotympanum following Streptococcus pneumoniae-induced otitis media. Streptococcus pneumoniae (Spn) are among the most frequently isolated pathogens in acute otitis media (AOM) and in otitis media with effusion (OME). Recently, the specific receptor for Spn has been identified as the trisaccharide unit Gal beta 1-4 GlcNAc beta 1-3 Gal beta with GlcNAc beta 1-3 Gal beta as the principal binding site. During the colonization of mucosal surfaces, pneumococci produce a variety of enzymes. This study was conducted to identify any resulting changes in the cell surface carbohydrate structure due to the action of these enzymes during pneumococcal otitis media (OM) in chinchillas. Using a lectin histochemical method with seven different lectins (SNA, LFA, WGA, Succ WGA, BSL II, PNA, ECL), the labeling pattern revealed not only the removal of the terminal sialic acid, but also the exposure of N-acetyl-glucosamine. These results suggested that Spn-produced enzymes uncover part of their own receptor structure and thus may facilitate adherence and subsequent infection.


Proliferative and T-cell specific interleukin (IL-2/IL-4) production responses in spleen cells from mice vaccinated with aroA live attenuated Salmonella vaccines. T-cell responses were studied in mice immunized with the Salmonella typhimurium aroA SL3261 live attenuated vaccine strain. T-cell responses in the spleen, both in whole cell populations and in nylon wool non-adherent (T-cell enriched) cells, were studied in vitro as proliferation by incorporation of tritiated thymidine and production of T-cell specific cytokines [IL-2 (interleukin-2)/IL-4]. Stimulating antigens included whole Salmonella lysates and purified lipopolysaccharide (LPS), both untreated and after alkaline hydrolysis to prevent the non-specific mitogenic effect of LPS. Strong proliferative responses were obtained with untreated whole cell extract and LPS, which were decreased by polymyxin B (PB). Alkaline detoxification of the antigens decreased the proliferative response of nylon-wool non-adherent populations to LPS, but greatly increased their response to the Salmonella extract. Surprisingly, PB also reduced proliferation to detoxified LPS. Little or no IL-2/IL-4 production was seen in response to LPS or purified polysaccharide antigens, while there was a strong IL-2/IL-4 response to whole cell lysate, again markedly increasing after alkaline treatment. The results suggest that the T-cell response elicited by immunization with live Salmonella aroA vaccines in mice recognizes antigens other than LPS determinants, and that estimation of T-cell responses to Salmonella antigens by proliferation alone may yield misleading results.


[The role of the endogenous opioid system in the pathogenesis of polycystic ovary syndrome: the altered neuroendocrine regulation of GnRH-LH is corrected after clomiphene therapy]. To investigate whether inappropriate LH secretion in Polycystic Ovary Syndrome (PCO) was related to a reduction of inhibitory opioid control on the GnRH-LH system, 23 women affected by PCO (12 obese, BMI: 37.1 +/- 3.9 and 11 non obese, BMI: 21.5 + 2.4) and 19 fertile women (10 obese, BMI: 38.8 + 1.8 and 9 non obese, BMI: 20.1 + 1.5) were studied. Plasma levels of Beta-Endorphin (B-Ep) in basal condition and LH and FSH serum levels following acute administration of naloxone (0.1 mg/kg e.v.) were evaluated in the PCO and control groups. Moreover, in order to investigate whether the neuroendocrine abnormalities in PCO are a primary hypothalamic defect or secondary to an inappropriate feedback of gonadal steroids, the LH response following Naloxone administration was evaluated again after two months of clomiphene therapy (50 mg p.os ones a day for 5 days). The women affected by PCO had increased LH/FSH ratio, testosterone levels (P < 0.001, P < 0.01) and significantly decreased T/E2 ratio, SHBG levels compared to the normal women (P < 0.01, P < 0.001). B-Ep plasma levels in PCOs OB and PCOs nOB (6.13 + 1.2 Pmol/L, 4.8 + 0.4 Pmol/L) were similar to those observed in obese and non obese control women (7.2 + 2.5 Pmol/L, 4.2 + 1.3 Pmol/L), respectively. In the PCO and control groups naloxone induced a significant increase of FSH and LH levels. Thus the area under the curve of LH and FSH was significant higher after naloxone, than following saline infusion both in PCO (P < 0.01, P < 0.05) and controls (P < 0.001, P < 0.001). However, in PCO the post naloxone FSH increase was similar to that found in fertile women, while the LH increase post naloxone was lower than that observed in controls (50 + 32.4% vs 101.6 + 36.7%; P < 0.01). Particularly in PCO with LH/FSH ratio equal or higher than 3, no significant variation of LH levels was found after naloxone. Moreover the LH increase post naloxone was similar in PCO OB (46 + 19.8%) and in PCO nOB (49.9 + 13.1%), correlated negatively with LH basal levels (P < 0.02), LH/FSH (P < 0.005), E1/E2 (P < 0.005) and was independent of T/E2, BMI and duration of the disease. Following clomiphene treatment, the LH response after naloxone was significantly higher than that observed before treatment (from 9.4 + 4.2 mUI/ml to 16.5 + 3.9 mUI/ml, P < 0.001).(ABSTRACT TRUNCATED AT 400 WORDS)


[Effect of 5-hydroxytryptophan on the secretion of PRL, GH, TSH and cortisol in obesity]. The role of the neurotransmitter serotonin (SER) in regulating the hypothalamic-pituitary function is not completely clarified, although considerable evidence suggests a dominant stimulatory control of ACTH and PRL and a dominant inhibition of TSH, with more variable effects on GH secretion. Furthermore, SER has been implicated in the regulation of appetite, given the anorectic activity of SERergic drugs in animals and humans and experimental evidence suggesting that animal obesity can be a function of SER depletion. In order to study the hypothesized impairment of the SERergic system in human obesity, PRL, GH, TSH and cortisol levels before and after oral administration of the SER precursor 5-hydroxytryptophan (OH-TRY) (500 mg), were determined in 10 obese (BMI 41.5 +/- 1.68 kg/m2) but otherwise healthy women (mean age 50.9 +/- 1.43 yr) and in control group of 7 normal-weight (BMI 20.9 +/- 0.66 kg/m2) women (mean age 49.8 +/- 1.18 yf) after oral administration of the SER precursor 5-hydroxytryptophan (OH-TRY) (500 mg). The results were matched against placebo. In contrast with placebo, OH-TRY administration provoked a PRL and cortisol increase in all the subjects: PRL levels increased in controls at 120 min (p < 0.05) and at 180 min (p < 0.01) and in obese women at 120 and 180 min (p < 0.01); cortisol levels increased in both groups at 90, 120, 180 min (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)


[Acute suppurative thyroiditis in a patient with prior subacute thyroiditis]. Acute suppurative thyroiditis is an uncommon thyroid disorder usually caused by bacterial infection. The most common route of infection is a fistula that originates from the fundus of the pyriform sinus. Pre-existing thyroid disease, most commonly nodular goiter, has been reported to be present in acute suppurative thyroiditis. A 44 year old man presented a subacute thyroiditis, resolved by nonsteroidal antiinflammatory treatment. One year later, the patient abruptly complained of fever and painful swelling in the thyroid region. A relapse subacute thyroiditis was diagnosed and prednisone treatment was started. A few days later owing to a worsening of the pain and of the clinical features the patient was referred to our department. He presented dysphagia and he was feverish, the overlying skin of the neck swelling was erythematous and warm. There was a neutrophilia (83.7%). Plasma FT4, FT3 and TSH were normal. Anterior neck region ultrasonography showed an enlargement of the left thyroid lobe with poorly defined shapes and inhomogeneous parenchyma while the right lobe of the gland was normal. The 131-I thyroid scan showed a large cold area in the upper part of the left thyroid lobe and preserved radionuclide uptake in the residual parenchyma. The RAIU was normal. We diagnosed acute suppurative thyroiditis and started antibiotics treatment. The day after the patient was still feverish and he gave out from the mouth a great quantity of sero-purulent material with a swelling reduction and improvement of the neck pain. Barium swallow examination did not show any fistula in the cervical esophagus. The fistula opening was demonstrated by indirect laryngoscopy in the postero-lateral side of hypopharynx.(ABSTRACT TRUNCATED AT 250 WORDS)


[Hemolysin from Vibrio cholerae eltor: cloning and expression of genes in Escherichia coli]. A 6.56-kb V. cholerae eltor DNA fragment encoding hemolysin synthesis was cloned in pUC18. The resultant recombinant plasmid pES4H (9.25 kb) was mapped by restriction analysis and shown to express in different E. coli strains as well as in nonhemolytic V. cholerae strains. Application of the cloned fragment as a molecular probe revealed homologous sequences in all V. cholerae strains tested independently on their biotypes, hemolytic activity and presence of vct-genes in their genomes while none of other Vibrio species and related microorganisms contained such sequences. A recombinant E. coli strain, a V. cholerae eltor hemolysin producer, was constructed. The simultaneous expression of hemolytic and toxinogenic properties by the same V. cholerae strains is discussed.


[Preparation and regeneration of protoplasts from Bacillus megaterium cells dried by sublimation]. Bacterial protoplasts are widely used in genetical research, for instance, in protoplasts fusion experiments and the transfer of heterologous DNA into bacterial cells. The usage of a new fresh grown culture of bacteria in every experiment restricts the reproducibility of the results preventing the technique becoming widespread. The use of antioxidants as components of stabilizing medium for sublimation drying of Bacillus megaterium cells supported cellular viability in bacterial culture. It also made possible preservation of such cellular fundamental properties as the ability to form protoplasts and regenerate the cell wall. Efficiencies of protoplasts formation and generation are similar for lyophilized and fresh grown cells. Cellular properties are conserved for 6 months of storage at least. Experiments with a lot of lyophilized biomass samples are highly reproducible. The potential of the technique was demonstrated in obtaining the hybrid Bacillus megaterium colonies by fusion of protoplasts derived from lyophilized genetically marked strains stored for up to 6 months.


[pH-dependent fusion of eukaryotic cells, caused by arenaviruses, pathogenic and non-pathogenic for humans]. The conditions necessary for fusion from inside (FFWI) of the BHK-21 cell culture affected by the Lassa and Mopeya arenaviruses were studied. The fusion was shown to occur only in the slightly acid medium and at lower pH meanings for the Mopeya virus, than for the Lassa virus.


[Kasugamycin methylase modified by ribosomal RNA from group A streptococci]. Kasugamycin sensitivity in Escherichia coli depends on the specific enzyme methylating rRNA. Native group A streptococci (GAS) were found to be sensitive to kasugamycin. After introduction of the erythromycin gene located on the transposon Tn916E into GAS some of the strains obtained kasugamycin resistance together with erythromycin resistance (erm). One of these strains carrying the transposon in its chromosome was tested for methylase activity. It was demonstrated to be deficient in kasugamycin methylase (ksg). The presented data proves the presence of ksg methylase in GAS. Evolutionary relationship between erm and ksg genes is discussed.


[A highly sensitive non-isotopic system of DNA hybridization using amplification (PCR) for identifying and indicating presence of Brucella]. A non-isotopic amplification system was used to identify and indicate Brucella. The terminal sequences of a protein gene fragment in Brucella outer membrane were identified and direct and reverse primers were chosen for a polymerase chain reaction. (PCR). PCR amplifies a specific DNA fragment, 700 kb in size, only in representatives of the Brucella genus. A probe was design, which is the central part of the amplified DNA fragment, 550 kb in size. Single Brucella cells were detectable with an unlabelled probe in the analyzed samples during hybridization reactions. The system can be recommended for a rapid and reliable analysis in medical and veterinary practice.


[Determination of thermostable and thermolabile enterotoxins in Escherichia coli strains by genetic, biological, and immunoserological methods]. The Escherichia coli strains (75) isolated from patients suffering from diarrhea were screened for ability to produce the temperature-labile or stable toxins (ST or LT) by the different techniques (the hybridization with DNA probes, biological, enzyme immunoassay). The majority of tested strains was shown to harbor the tox-genes controlling the synthesis of ST, LT or both enterotoxins. However, the phenotypic expression of the genes was registered in only some of the strains. The hybridization with the DNA probes is noted to be most perspective in the mass screening of toxigenic strains. The DNA probe used contained the fused estA-eltB genes that makes one able to detect the genes for both enterotoxins.


[Search for unique segments of the ectromelia virus genome by cross blot hybridization with DNA from other orthopoxviruses]. In order to identify ectromelia virus (EMV) genome regions which may contain genes responsible for the specific pathogenicity of this virus, blot cross-hybridization of EMV DNA with those of other orthopoxviruses was performed. Two hybridization schemes were employed: one of them included hybridization of labelled cloned fragments of EMV with digests of other viral DNAs, the other, reciprocal, consisted in hybridization of labelled total DNAs of various orthopoxviruses with digests of the region of EMV DNA adjacent to the right-terminal inverted repeat. It was demonstrated that the counterpart to an approximately 8-kilobase pair portion of EMV genome flanking the inverted repeat could be detected only in the cowpox virus genome but not in the genomes of vaccinia and rabbitpox viruses. XhoI-O and XhoI-K fragments of EMV DNA contained, along with genes found in other poxviruses, certain genes which appeared to be unique for EMV. It is postulated that some of these genes may determine the specific biological properties of EMV, including its pathogenicity for mice.


[Cloning the gene for vaccinia virus strain L-IVP growth factor in Escherichia coli]. The growth factor gene of the vaccinia virus LIVP strain has been primarily cloned in a 4.3 kbp long BamHI-EcoRI fragment and then subcloned in a 440 bp fragment. It was shown that clone 4 of the LIVP strain contains a single copy of this gene while the WR strain contains a repeat. The gene is located on a 4.3 kbp BamHI-EcoRI fragment but not on a 2.2 kbp fragment and has four nucleotide changes, three of which result in amino acid substitutions.


[DNA probe for detecting Yersinia pestis and serovariant I of Yersinia pseudotuberculosis by detecting specific DNA repeating sequences]. In order to construct a DNA probe for the plague pathogen detection, we have obtained the recombinant plasmid pRD100 carrying an EcoRI-flanked 140 bp fragment from the genetically silent region of Yersinia pestis species-specific plasmid pYP1. When used as a DNA probe for hybridization of DNA from various strains of 25 bacterial species, this DNA fragment was shown to have the complementary sequences in all investigated Yersinia pestis strains (200), including the plasmid pYP1 lacking ones, and in all the studied Yersinia pseudotuberculosis serotype I strains (80). The search for the probe target in these species has led us to conclusion that it is a specific repeated DNA sequence present in more copies in Yersinia pestis than in Yersinia pseudotuberculosis serotype I. The hybridization of these sequences with the radioactive probe and 24 hours autography makes possible the detection of 1.3 x 10(5) cells of Yersinia pestis and 3 x 10(6) cells of Yersinia pseudotuberculosis serotype I immobilized on the nitrocellulose membranes. Use of the probe for analysis of the nitrocellulose membrane fixed spleen smears from animals that died of experimental plague made possible the detection of Yersinia pestis cells within 48 h.


[Serovariation of the plague pathogen capsular antigen]. The phenomenon of serovariation in the capsule antigen of the plague pathogen has been found. The synthesis of FI-serovar is determined by the expression of the caf1M gene. The damages in the caf1M gene structure result in production of the FI1 and FI2 serotypes. Expression of the caf1M gene does not affect the secretion of FI-antigen.


[Azospirillum brasilense SP245 mutants in production of anthranilic and indolyl-3-acetic acids]. The mutants of Azospirillum brasilense Sp245 altered in the production of anthranilic (Ant) and indolyl-3-acetic (IAA) acids were selected after the chemical or transposon facilitated mutagenesis and divided into the following three classes: Ant+IAA+, Ant+IAA- and Ant-IAA-. A hypothesis on the existence of a pattern for tryptophan conversion to anthranilate that is different from the classic pattern, and on the connection of the indolyl-3-acetic synthesis with this process is suggested.


[Change in regulation of influenza virus vRNA synthesis during adaptation to various hosts]. To evaluate the effect of laboratory passaging of influenza virus A/USSR/90/77 (H1N1) on the pattern of vRNA synthesis regulation in course of the one step infection cycle, we have used the viral variants adapted to growth in the continuous cell line MDCK or to the reproduction in the mice lungs in vivo. Enhancement of regulation was registered in the adapted variants as compared to the original virus strain. The results are discussed in connection with possible significance of the vRNA synthesis regulation for the efficiency of viral reproduction under natural conditions or in laboratory passaging.


[Plasmid P85 from Azospirillum brasilense SP245: study of the circle of possible hosts and incompatibility with plasmids from Azospirillum brasilense SP7]. The possibility of the stable inheritance of the plasmid p85 mobilized derivatives from Azospirillum brasilense Sp245 in the cells of the bacterial genera Rizobiaceae (Agrobacterium tumfaciens) and Pseudomonadaceae (Pseudomonas putida) has been shown. The plasmid p85 participates in coding for the physiologically active products (the plant hormones). It is not inherited by the Escherichia coli strains. For the first time the incompatibility of azospirillium plasmids has been demonstrated on the example of the plasmid p85 from Azospirillum brasilense Sp245 and the plasmid p115 from Azospirillum brasilense Sp7.


[Allergy to beta-lactam antibiotics in childhood. Diagnostic problems]. This study reports about 126 children with an age ranging from 12 months to 12 years having RA to beta-lactamase. More children with an age ranging from 7-12 years (59.5%), and more male (65.9%) than female subjects were studied. 76 patients (60.3%) showed a familial anamnesis of allergic diseases or similar diseases and a personal anamnesis of allergic diseases (45.2%). Among the RA responsible substances the more frequent were semisynthetic penicillin (44.6%) followed by cephalosporin and penicillin. Most clinical manifestations (87.3%) were cutaneous reactions and in smaller number of cases it was possible to observe gastroenteric or respiratory reactions. In 121 patients cutaneous tests were undertaken (Prick tests and intradermoreactions), patch tests, employing: PPL, MDM, Penicillin, Ampicillin, Cephaloridine. 5.8% of the studied subjects showed an allergy. Particularly 2.4% showed a "early" positivity. RAST was carried out in 92 patients and 3 of them showed a positive result (3.2%). This study stresses the opportunity to carry out allergologic tests within 6 months since the beginning of RA. In fact especially in children this test result can soon become negative. Furthermore the reduced percentage of positive allergologic tests can be due to the inclusion in other studies of patients with "coincidental reactions". A certain number of RA can be caused by additive to "per os" products. Finally it will be possible to use "tests dose" even in selectioned cases. These tests can frequently exclude the etiopathogenetic responsibility of beta-lactamic substances.


[Role of "leukocyte adhesion molecules" in early periodontal disease]. The purpose of this paper is to focus on functional characteristics of leukocyte adhesion molecules, on their localization and specific ligands. In fact, leukocyte chemotaxis and adhesion to endothelium is an essential step in promoting adequate immune response to bacterial infections. Since periodontal health is highly dependent on neutrophil function against the microbial dental plaque, defects in chemotaxis and adhesion of leukocytes to endothelium often result in severe, early onset periodontitis. Furthermore, oral lesions may be the only clinical manifestation of neutrophil impairment.


[Specific IgA against multiple antigens as expression of immunologic deregulation in HIV-positive children]. B-cell dysfunction in HIV-infected children is reflected by hypergammaglobulinemia and high levels of serum IgA. Little is known about antibody specificity since only a small portion of serum IgA appears to be directed against HIV proteins. In the present study the specificity of IgA antibodies against food, inhalant, bacterial and fungi antigens were evaluated in a population of HIV infected children. ELISA method was used for antibody testing. Our results show that in 84.6% of patients IgA against at least one food antigen are present. IgA against inhalant allergens were present in most of HIV-infected children but in none of controls. As for anti-tetanus toxoid antigens and anti-fungi antigens, though present in higher percentage in patients, specific IgA were found also in healthy children. If a gastrointestinal dysfunction might be supposed as the cause of presence of anti-food antigen IgA, it is difficult to consider this factor as the cause of presence of specific IgA directed against different antigens. It is possible to postulate that an immunologic dysregulation based on an imbalance between Th1 and Th2 cells or on higher levels of IL-5 and/or IL-6 may lead to a misfunction of B cell and consequently to hypergammaglobulinemia with high IgA levels.


[Erratic feeding habits in infants and secondary diseases: findings from a caseload of 440 patients]. The alimentary habits have been analyzed in 440 infant with acute and chronic disease of nutrition. It has been observed a high incidence of dietetic mistakes, whether qualitative or quantitative. These mistakes appeared in correlation with the poor cultural and socio-economic conditions of the population. The Authors compare the observed pathology with the wrong alimentary habits conditioned by low social context and suggest an adequate prophylaxis of infant's nutrition disease, thorough better alimentary habits in childhood and better life conditions of the population.


[The adolescent celiac].

[The adolescent celiac]. A group of 81 teenage coeliac patients were recently followed to monitor their compliance with a gluten free diet and also to correlate this with: their general wellbeing, height and weight, antigliadin and antiendomisyal antibody levels and jejunal mucosa patterns. Fifty two patients (64.1%) were on a strict gluten free diet; 18 (22.3%) admitted an occasional gluten intake; 11 (13.6%) were on a normal diet. Symptoms were more frequent in non-compliers that in compliers. There was no appreciable difference between the groups in regard to height and body-mass index, but patients on a normal diet were lighter than the others. Small bowel biopsy was performed on 18 patients with various histological findings. Antigliadin antibodies and antiendomysium antibodies were good indications of a patient's gluten free diet compliance and mucosal damage.