Calbindin D-28k distribution in odontoblasts underneath tertiary dentine in human carious teeth

OBJECTIVE: The aim of this study was to examine the calbindin D-28k immunoreactivity in carious teeth to know whether this protein may have a function in tertiary dentine formation. METHODS: Human extracted teeth with or without carious lesions were immersion-fixed with Zamboni fixative, demineralized in 4.13% EDTA solution (pH 7.4), frozen-sectioned, and processed for calbindin immunoreactivity and hematoxylin-eosin stain. The intensity of the immunostaining was evaluated by quantitative densitometry. RESULTS: In intact teeth, numerous odontoblasts were aligned underneath the secondary dentine and their cell bodies showed the immunoreactivity. In carious teeth, tertiary dentine had poor- or rich tubular patterns under the carious lesion. Underneath the tubule-poor tertiary dentine, distinct odontoblasts could not be seen at the central site. However, some cells with a flat appearance were located at this site and were immunonegative for calbindin D-28k. On the other hand, columnar odontoblasts were seen at the peripheral site, and their cell bodies and processes showed strong immunoreactivity. Underneath the tubule-rich tertiary dentine, columnar odontoblasts were abundantly distributed, and the strong immunoreactivity was observed in their cell bodies and processes. The immunoreactivity in odontoblasts underneath the tertiary dentine with poor or rich tubular pattern was more intense than that for the secondary dentine in intact teeth (P<0.05). On the other hand, the intensity of the immunoreactivity in odontoblasts was similar underneath the secondary dentine in intact and carious teeth. CONCLUSIONS: The present study demonstrated that calbidin D-28k was actively synthesised by odontoblasts under the carious lesion. These findings may suggest that this protein plays an important role in the tertiary dentine formation.     

Mapping energy metabolism in jaw and tongue muscles during chewing

Investigators have used positron emission tomography with 18F-fluoro-D-deoxyglucose to obtain information not only for the diagnosis of cancers, but also for researching physiology in skeletal muscles. The aim of this study was to evaluate the activities of the jaw and tongue muscles during gum-chewing. Five volunteers aged 32-61 years were studied by positron emission tomography. They were requested to chew two pieces of chewing gum for 30 min after intravenous injection of 18F-fluoro-D-deoxyglucose. 18F-fluoro-D-deoxyglucose uptake in the intrinsic tongue muscle was significantly (p < 0.05) higher than that in the masseter, temporal, and medial pterygoid muscles. Heterogeneous uptake of 18F-fluoro-D-deoxyglucose was observed in the masticatory muscles. In addition, the tongue exhibited higher activity than the masticatory muscles. In conclusion, positron emission tomography with 18F-fluoro-D-deoxyglucose appeared to be a useful technique for investigating the physiologic activities of the skeletal muscles, which have been difficult to examine by conventional methods.     

Effect of two-step adhesive systems on inhibition of secondary caries around fluoride-releasing resin composite restorations in root dentine

OBJECTIVE: The purpose of this study was to investigate the effect of two-step adhesive systems on secondary caries inhibition around fluoride-releasing materials in vitro. METHODS: Two self-etching primer systems, Clearfil SE Bond (SE) and UniFil Bond (UB), and two one-bottle systems with a total-etch wet-bonding technique, Single Bond (SB) and One-Step (OS), were used prior to placement of resin composites either with (Reactmer) or without (Z100) fluoride release. Class V cavities prepared in extracted human premolars were restored with various combinations of materials: Reactmer/SE, Reactmer/UB, Reactmer/SB, Reactmer/OS, Z100/SE, Z100/UB, Z100/SB and Z100/OS. After storage for 14 days, the restored teeth were incubated in bacterial medium containing sucrose with Streptoccus mutans for 2 weeks. Water sorption and desorption of the adhesives and fluoride release from the resins either coated with adhesive or uncoated were also determined. RESULTS: The one-bottle groups showed higher water sorption and desorption than the self-etching primer groups. Although fluoride release from the Reactmer specimens was suppressed by the adhesive coating, the one-bottle groups allowed significantly higher fluoride release than the self-etching primer groups. On microradiographs, the radio-opaque layers adjacent to the Reactmer restorations were thick and clear, while the layers adjacent to the Z100 restorations were thin and unclear. For the Reactmer restorations, the radio-opaque layers associated with the one-bottle groups were significantly thicker than for the self-etching primer groups. CONCLUSIONS: These results indicated that the use of one-bottle wet-bonding systems for bonding of fluoride-releasing resin composites to dentine may contribute to inhibit secondary caries compared to self-etching primer systems.     

A nationwide analysis of clinical outcomes among newborns with esophageal atresia and tracheoesophageal fistulas in the United States

Background

The aim of this study was to examine national outcomes in newborn patients with esophageal atresia and tracheoesophageal fistula (EA/TEF) in the United Sates.

Methods

Kid's Inpatient Database (KID) is designed to identify, track, and analyze national outcomes for hospitalized children in the United States. Inpatient admissions for pediatric patients with EA/TEF for kid's Inpatient Database years 2000, 2003, 2006, and 2009 were analyzed. Patient demographics, socioeconomic measures, disposition, survival and surgical procedures performed were analyzed using standard statistical methods.

Results

A total of 4168 cases were identified with diagnosis of EA/TEF. The overall in-hospital mortality was 9%. Univariate analysis revealed lower survival in patients with associated acute respiratory distress syndrome, ventricular septal defect (VSD), birth weight (BW) < 1500 g, gestational age (GA), time of operation within 24 h of admission, coexisting renal anomaly, imperforate anus, African American race, and lowest economic status. Multivariate logistic regression identified BW < 1500 g (odds ratio [OR] = 4.5, P < 0.001), operation within 24 h (OR = 6.9, P < 0.001), GA <28 wk (OR = 2.2, P < 0.030), and presence of VSD (OR = 3.8, P < 0.001) as independent predictors of in-hospital mortality. Children's general hospital and children's unit in a general hospital were found to have a lower mortality rate compared with not identified as a children's hospital after excluding immediate transfers (P = 0.008).

Conclusions

BW < 1500 g, operation within 24 h, GA < 28 wk, and presence of VSD are the factors that predict higher mortality in EA/TEF population. Despite dealing with more complicated cases, children's general hospital and children's unit in a general hospital were able to achieve a lower mortality rate than not identified as a children's hospital.     

Multiple Hepatic Vein Reconstruction Using an All-in-one Sleeve Patch Graft Technique in Living Donor Liver Transplantation: A Case Report

Maintaining hepatic inflow and appropriate venous drainage is important for maximizing the capacity of the retrieved graft in liver transplantation. Here, we report a successful case of multiple hepatic vein (HV) reconstruction using an all-in-one sleeve patch graft of the autologous great saphenous vein to ensure adequate blood flow through the HV. A patient with hepatocellular carcinoma caused by hepatitis C virus–induced cirrhosis underwent living donor liver transplantation using a right lobe graft. A preoperative dynamic computed tomography scan and intraoperative findings revealed that the graft had three middle HV tributaries, a superficial vein, segment VIII HV (V8), and segment V HV (V5). The openings of the superficial vein and V8 were located very close to that of the right hepatic vein (RHV) in the cutting surface. Each HV had significant diameter and drainage territory requiring reconstruction. An autologous great saphenous vein was used to create a sleeve patch to incorporate the close-packed HV openings. The autologous sleeve patch graft was sutured to the openings of the RHV and the superficial vein and the hole created on the sleeve patch graft was anastomosed to the openings of V8 directly on the back table to create an all-in-one sleeve patch. For the V5 reconstruction, the recipient's intrahepatic portal vein graft was used to create an interpositional conduit from the recipient's V5 to the inferior vena cava. The postoperative course was uneventful and postoperative studies revealed good graft function with excellent blood flow in the HV.     

Risk Factors for Development of New-Onset Diabetes Mellitus and Progressive Impairment of Glucose Metabolism After Living-Donor Liver Transplantation

Background

New-onset diabetes mellitus (NODM) has a negative impact on graft and patient survivals. Hepatitis C virus (HCV) infection, high body mass index, increased donor and recipient ages, and calcineurin inhibitor (CNI) type have been identified as risk factors for the development of NODM. We aimed to elucidate the risk factors for the development of NODM and those for progressive glucose intolerance in adult living-donor liver transplant (LDLT) recipients.

Methods

We collected data from 188 primary liver transplant recipients (age > 16 years) who underwent LDLT from June 1991 to December 2011 at Hiroshima University Hospital. Risk factors for NODM and progressive impairment of glucose metabolism in pre-transplantation diabetes mellitus (DM) recipients were examined.

Results

Pre-transplantation DM was diagnosed in 32 recipients (19.3%). The overall incidence of NODM was 6.0% (8/134 recipients). Multivariate analysis revealed that old recipient age (≥55 years) is a unique predictive risk factor for developing NODM. The incident of pre-transplantation DM was significantly higher in recipients with HCV infection than in those without HCV. A high pre-transplantation triglyceride level was an independent risk factor for progressive impairment of glucose tolerance among 32 LDLT recipients with pre-transplantation DM. All of the NODM patients were being treated with tacrolimus at the time of diagnosis. Switching the CNI from tacrolimus to cyclosporine allowed one-half of the patients (4/8) to withdraw from insulin-dependent therapy. NODM and post-transplantation glucose intolerance had no negative impact on patient and graft outcomes.

Conclusions

Older age of the recipient (≥55 years) was a significant risk factor for NODM. Hypertriglyceridemia in the recipients with DM is an independent risk factor for post-transplantation progressive impairment of glucose metabolism. NODM had no negative impact on outcomes in the LDLT recipients.