Susceptibility weighted imaging in infants with staged embolization of vein of Galen aneurysmal malformations

Background and purpose

The vein of Galen aneurysmal malformation (VGAM) is a rare congenital vascular malformation with a higher morbidity and mortality, especially in neonates. Ultrasound, CT and MR are usually used in diagnosis and treatment monitoring of these disorders. In this current study, we aim to examine utility of SWI in evaluation of treatment response in infants with VGAM.

Clinical outcomes for early childhood caries: influence of aggressive dental surgery

PURPOSE: The objective of this study was to assess the relationship between the number of stainless steel crowns (SSCs) placed, number of surfaces at risk (SAR) post dental surgery, and the risk for relapse in patients treated for Early Childhood Caries (ECC). METHODS: The study population consisted of 57 children treated for ECC under general anesthesia, ranging in age from 2.3 to 7.3 years old at the time of entry. Dental surgery utilized an aggressive approach: teeth that had necrotic pulps or were nonrestorable were extracted; decayed primary mandibular incisors that could not be treated by stripping were extracted; primary maxillary incisors with 3 or more carious surfaces were extracted; single-surface lesions of primary molars that did not compromise cusp integrity were restored with intracoronal amalgam restorations; primary maxillary, incisors and canines with smooth-surface lesions affecting 2 or less surfaces were treated with intracoronal composites; primary molars and canines requiring vital pulp therapy were restored with SSCs; primary molars with caries lesions affecting 2 or more surfaces (including smooth-surface, white-spot lesions) were restored with SSCs; primary canines with caries affecting 3 or more surfaces were restored with stainless steel crowns; topical fluoride was applied after all restorative therapy was completed. The cohort was examined for new caries lesions 6 months post dental surgery. Relapse was defined as the presence of new smooth-surface caries lesions as defined by Radike. Comparisons between relapse (R) and nonrelapse (NR) groups, with respect to the number of SSCs placed and the number of SAR, were performed using t tests and Wilcoxon tests. A 0.05 level of significance was employed in all statistical tests. RESULTS: Twenty-one of the 57 (37%) patients relapsed. No statistically significant difference for the number of SSCs placed or SAR existed between the R group (SSCs: mean = 4.57, median = 4 +/- 2.18; SAR: mean = 39.76, median = 40 +/- 13.62) and NR group (SSCs: mean=5.44, median = 5.5 +/- 2.62; SAR: mean = 39.98, median = 39.5 +/- 15.19). CONCLUSIONS: The risk for relapse in children treated for ECC is not associated with the number of SSCs placed or SAR; aggressive dental surgery for ECC does not result in acceptable clinical outcomes.     

Primary oral infection of infants with Streptococcus mutans

Strep. mutans was not detected in 16 normal predentate infants, but was isolated from $\text{3}\text{43}$ infants with 1 to 5 primary incisor teeth and $\text{12}\text{42}$ infants with 6 to 8 incisors. The salivary level of Strep. mutans was determined for the 42 mothers of the infants with only 6 to 8 incisors. The difference in the distribution of the salivary levels of Strep. mutans within the maternal populations of infected versus non-infected infants was statistically significant (p = 0.03). Ten mothers harboured greater than 10⁵ colony-forming units (CFUs) of Strep. mutans per ml. saliva. The organism was detected in 6 of their infants. Of 13 mothers with levels less than 10³ CFUs per ml. saliva only 2 of their infants harboured the organism.     

Similarity of bacteriocins of Streptococcus mutans from mother and infant

Bacteriocin typing has been used as an epidemiological tool for tracing bacterial infections in man. The production of bacteriocins by 120 Streptococcus mutans isolates from 4 mother-infant pairs was studied to test the likelihood of maternal transmission of this species. The patterns of inhibition were sufficiently different to allow differentiation of the 120 isolates into 42 bacteriocin types. The bacteriocin codes of isolates within one pair did not correspond to the codes of strains isolated from any other pair examined. The number of infant strains (per 10 infant isolates) matching maternal strains within each mother-infant pair were $\text{5}\text{10}$, $\text{10}\text{10}$, $\text{7}\text{10}$, and $\text{9}\text{10}$ for each of the pairs respectively. The results demonstrated significant intra-pair homogeneity of Strep. mutans strains based on bacteriocin production.     

A vertical cephalometric analysis of the human craniofacial complex.

A vertical analysis involving ten linear measurements was developed to localize skeletal and dentoalveolar dysplasias. The measurements are of biologic relevance, reflecting the amount of growth harmony or disharmony to the examination and record-taking time. The vertical dimensional analysis uses the age- and sex-related University of Michigan mean values for comparative data for each measurement. Ratios were computed for a five-unit proportional analysis. Both analyses were applied to assess the vertical problems of three female patients. The analyses detected specific areas of dysplasia for each patient.     

Antibacterial treatment needed for severe early childhood caries

OBJECTIVES: To assess the effects of a single 10% povidone iodine application as an adjunct to extensive surgical procedures in the clinical treatment of children with early childhood caries. METHODS: Twenty-two children scheduled for dental treatment under general anesthesia were randomized into either an intervention group (10% povidone iodine), or a control group (phosphate buffered saline). Either povidone iodine or phosphate buffered saline was applied to teeth and soft tissues after prophylaxis and all operative dental procedures, followed by 1.23% acidulated phosphate fluoride gel. Saliva samples taken at baseline, and after 1 hour, 3 weeks and 3 months were assayed for mutans streptococci, lactobacilli and total viable bacteria. Caries lesions were recorded at baseline and at one year. RESULTS: Mutans streptococci and lactobacilli levels in the povidone iodine group were significantly reduced relative to baseline at 1 hour, 3 weeks and 3 months. At one year at least 60% of subjects had new caries lesions in each group, and there was no significant difference in caries increment between the two groups. CONCLUSIONS: Even prophylaxis, fluoride gel application and complete surgical treatment of caries at baseline were insufficient to prevent new caries in over 60% of the patients in these high caries risk infants. Although the one-time treatment with povidone iodine reduced mutans streptococci and lactobacilli levels for up to 3 months this therapy failed to additionally reduce future caries formation over one year, indicating that repeated antibacterial treatments will be needed to control high levels of cariogenic bacteria.     

Aesthetic concerns of children and parents in relation to different classifications of the Tooth Surface Index of Fluorosis

Abstract –Increasing prevalence of dental fluorosis for children both from fluoridated and non-fluoridated communities are now well documented. Along with recent studies purporting possible adverse health effects from fluorides, this proven public health intervention is again being challenged. This study was undertaken to determine the prevalence of dental fluorosis for children from fluoridated and non-fluoridated areas in British Columbia. In addition, children and parents were provided with an opportunity to express concerns about the aesthetics of the child's anterior teeth. Children from representative schools in two communities were surveyed using the Tooth Surface Index of Fluorosis (TSIF). Questionnaires were sent home to parents to detail their child's use of various fluoride preventive practices and residence histories. Completed questionnaires were returned and exams were performed on 1131 children. Of those examined, 60% had dental fluorosis on at least two tooth surfaces, only 8% had scores ranging from "2" to "6", and 52% were classified with a score of "1". Parental and child ratings on the aesthetics or color of the child's teeth suggests that there are few children with aesthetic problems in the TSIF category of "1". While concerns of parents were more common, the actual source of those concerns was not assessed in the questionnaire. Not unexpectedly, children with fluorosis on anterior teeth ranging between TSIF scores of "2" to "6" appear to have increased concerns about tooth color. Data from children with confirmed residence histories from fluoridated communities suggest that the occurrence of aesthetic problems in these children is rare.     

Immune cell infiltration in malignant middle cerebral artery infarction: comparison with transient cerebral ischemia

We tested whether significant leukocyte infiltration occurs in a mouse model of permanent cerebral ischemia. C57BL6/J male mice underwent either permanent (3 or 24 hours) or transient (1 or 2 hours+22- to 23-hour reperfusion) middle cerebral artery occlusion (MCAO). Using flow cytometry, we observed ∼15,000 leukocytes (CD45^+high cells) in the ischemic hemisphere as early as 3 hours after permanent MCAO (pMCAO), comprising ∼40% lymphoid cells and ∼60% myeloid cells. Neutrophils were the predominant cell type entering the brain, and were increased to ∼5,000 as early as 3 hours after pMCAO. Several cell types (monocytes, macrophages, B lymphocytes, CD8⁺ T lymphocytes, and natural killer cells) were also increased at 3 hours to levels sustained for 24 hours, whereas others (CD4⁺ T cells, natural killer T cells, and dendritic cells) were unchanged at 3 hours, but were increased by 24 hours after pMCAO. Immunohistochemical analysis revealed that leukocytes typically had entered and widely dispersed throughout the parenchyma of the infarct within 3 hours. Moreover, compared with pMCAO, there were ∼50% fewer infiltrating leukocytes at 24 hours after transient MCAO (tMCAO), independent of infarct size. Microglial cell numbers were bilaterally increased in both models. These findings indicate that a profound infiltration of inflammatory cells occurs in the brain early after focal ischemia, especially without reperfusion.     

Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.