Bacteria in infected root canals of teeth evincing chronic apical periodontitis lesions were identified by a polymerase chain
reaction–denaturing gradient gel electrophoresis (PCR-DGGE) approach. DNA was extracted from root canal samples, and part
of the 16S rRNA gene of all bacteria was amplified by PCR and separated by DGGE, generating banding patterns representative of the community
structure. Twenty visible bands were cut out of the gel, re-amplified, and sequenced to provide identification. Sequencing
analysis revealed the presence of both cultivable and as-yet-uncultivated species in the samples analyzed, including representatives
of the genera Fusobacterium, Bacteroides, Dialister, Synergistes, Prevotella, Eubacterium and Peptostreptococcus. Unambiguous identification was not always possible and the method’s limitations are discussed. In general, the findings
showed that PCR-DGGE can be useful for the identification of both cultivable and as-yet-uncultivated bacteria in endodontic
infections. 相似文献
Introduction: Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today’s critical care unit is also linked to its multiple pharmacological effects.
Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing re-oxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin.
Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale. 相似文献
During the emergency work at the Fukushima Daiichi Atomic Power Plant (APP), the Tokyo Electric Power Company (TEPCO) and the Japanese government experienced various problems in medical and health care management issues, including special medical examinations, on-site triage and initial treatment, patient transportation, lodging and food, and long-term health care for emergency workers. To resolve these problems, the Ministry of Health, Labor and Welfare (MHLW) issued a series of compulsory directives and provided administrative guidance to TEPCO. Based on the experiences and lessons learned, the MHLW recognized that the proper management and implementation of medical and health care management in response to a similar accident would require sufficient measures and systematic preparation, including the following:
1. In case of large-scale nuclear accidents, the government needs to assist in dispatching medical staff to the affected plants.
2. Nuclear facility operators, medical facilities and fire departments should make an agreement to clarify the division of the roles played prior to the accident and should conduct emergency drills periodically with the full attendance of related personnel to identify and resolve the problems.
3. Operators need to develop a support base at a safe distance from the plant and to prepare to develop makeshift lodgings in case of emergency.
4. Operators need to come to an agreement to share food stocks among closely located nuclear plants and prepare cooking equipment that can be used in case of blackout to provide warm foods and drinks to as many workers as possible.
5. It is necessary to conduct long-term follow-up for emergency workers, including health care system, medical examinations and mental health consultations. 相似文献
This study evaluated the frequency, severity and outcome of complications in the clinical course of tako-tsubo cardiomyopathy (TTC).
Background
TTC is regarded as a benign disease since left ventricular (LV) function returns to normal within a short time. However, severe complications have been reported in selected patients.
Methods
From 37 hospitals, 209 patients (189 female, age 69 ± 12 years) were prospectively included in a TTC registry.
Results
Complications developed in 108/209 patients (52%); 23 (11%) had > 2 complications. Complications occurred median 1 day after symptom onset, and 77% were seen within 3 days. Arrhythmias were documented in 45/209 patients (22%) including atrial fibrillation in 32 (15%) and ventricular tachycardia in 17 (8%). Of 8 patients resuscitated (4%), 6 survived. Additional complications were right ventricular involvement (24%), pulmonary edema (13%), cardiogenic shock (7%), transient intraventricular pressure gradients (5%), LV thrombi (3%) and stroke (1%). During hospitalization, 5/209 patients (2.5%) died. Patients with complications were older (70 ± 13 vs 67 ± 10 years, p = 0.012), had a higher heart rate (91 ± 26 vs 83 ± 19/min, p = 0.025), more frequently Q\ waves on the admission ECG (36% vs 21%, p = 0.019) and a lower LV ejection fraction (47 ± 15 vs 54 ± 14%, p = 0.002). Multivariate regression analysis identified Q-waves on admission (OR 2.49, 95% CI 1.23–5.05, p = 0.021) and ejection fraction ≤ 30% (OR 4.03, 95% CI 1.04–15.67, p = 0.022) as independent predictors for complications.
Conclusions
TTC may be associated with severe complications in half of the patients. Since the majority of complications occur up to day 3, monitoring is advisable for this time period. 相似文献
IntroductionThe morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro–computed tomographic scanning.MethodsForty-seven extracted maxillary molars were scanned with a micro–computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test.ResultsThe palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8–11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13–15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation.ConclusionsThe absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5–1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals. 相似文献