Effectiveness of different cleaning agents against the colonization of Candida spp and the in vitro detection of the adherence of these yeast cells to denture acrylic surfaces

PURPOSE: The aim of this study is to examine the effect Klorhex and Fittydent, which are used as cleaning agents on the adhesion of Candida on the surfaces of acrylic denture and palatal mucosa. In addition, ability of yeasts to adhere to acrylic strips was evaluated after applying these agents in vitro. MATERIALS AND METHODS: Each group of 15 patients cleaned their dentures with either Klorhex or with Fittydent. The control group cleaned their dentures with water. RESULTS: It was found that 62.2% of the patients had colonies of Candida species on their palatal mucosa which was reduced to 51.1% after using these cleaning agents. The colonization rate with Candida spp on their dentures was reduces from 82.2% to 68.8% using these cleaning agents. The mean adhesion value of the Candida strains isolated from the acrylic strips were found to be 75 cell/strip prior to applying the Klorhex and Fittydent and 37.5 cell/strip and 15 cell/strip after applying these agents, respectively. CONCLUSION: These results showed that Klorhex and Fittydent have a certain preventive effect on the colonization rate of Candida spp on the surface of these dentures, the palatal mucosa, as well as on the acrylic strips in vitro.     

Immunodeficiencies in chronic muco-cutaneous candidosis

Cell-mediated and humoral immune responses have been investigated in fifteen patients with chronic muco-cutaneous candidosis and appropriate controls. An impaired cellular response to Candida albicans was found in all patients by the cytotoxicity test, using specifically activated lymphocytes which were reacted against ⁵¹Cr labelled chicken red cells. Migration of guinea-pig macrophages was not inhibited by supernatants from stimulated leucocyte cultures in eleven out of twelve patients and similar results were found when these patients were skin tested for delayed hypersensitivity. A significant though low grade lymphocyte transformation reaction was detected in five patients, two of whom yielded a negative delayed skin reaction. Responses to unrelated antigens, such as PPD and Herpesvirus hominis Type 1 were also impaired in some patients but to a lesser extent than to Candida albicans. It is suggested that chronic muco-cutaneous candidosis shows a spectrum of increasing cell-mediated immunodeficiencies which can be ranked into six grades. Chronic oral candidosis has a limited cellular immune defect (Grades A, B and C) whereas in the muco-cutaneous candidosis a more severe immunodeficiency is found (Grades D, E and F). Serum IgG and IgM antibodies to Candida were largely impaired in all but one grade of immunodeficiency (Grade E), whereas salivary IgA antibodies were deficient in the three more severe grades of immunodeficiencies (D, E and F).     

Studies on the incidence of Trichomonas vaginalis amongst pregnant women in Jos area of Plateau State, Nigeria.

An investigation was carried out on the incidence of Trichomonas vaginalis amongst pregnant women in Jos area of Plateau State, Nigeria. The pregnant women were made up of 250 women from Jos metropolis and 250 women from Jos rural area. Jos Metropolis women were found to have 37.6% rate of infection while Jos rural women were found to have 24.8% rate of infection. The pH range of the infected women was found to lie between 6-8. Their vaginal discharges were found to be frothy and greenish-yellow with a typical odour. Some had vulval irritations. Some reported that they had slight temperature rises above 37 degrees C in the nights. The infected women either belonged to the working class or were self employed. There was more infection amongst the working class women in the metropolis while the opposite was the case in Jos rural area. Some of the infected women had trichomoniasis alone while some were found to have mixed infection like trichomoniasis and candidosis, trichomoniasis and gonorrhoea or trichomoniasis, candidosis and gonorrhoea. The implications of these results are discussed.     

Synaptic potentials produced in jaw-closer and jaw-opener motoneurons by palatal stimulation

Summary Excitation and inhibition of temporal and digastric motoneurons (Temp. and Dig. Mns) during transient jaw closing, the so-called jaw-closing reflex, were studied in cats. Application of diffuse pressure stimulation to the posterior palatal surface produced the jaw-closing reflex and it was found that mechanosensory inputs from the posterior palatal mucosa produce depolarizing potentials on the Temp. Mns responsible for jaw closure during the jaw-closing reflex. We have demonstrated that in one-third of 27 explored Temp. Mns the initial bursts of spikes were elicited before the onset of jaw closure, suggesting that these cells contribute to initiate jaw closure during the jaw-closing reflex. The remaining cells probably contributed to maintain the occlusal phase. Furthermore, it was found that mechanosensory inputs from the posterior palatal mucosa produce a hyperpolarization-depolarization sequence in the Dig. Mns responsible for the jawclosing reflex. In addition, when pressure stimulation was applied to the anterior palatal mucosa, sustained jaw opening was elicited and an increase of firing frequency of Dig. Mns occurred 40 ms before the onset of jaw opening and continued for 80 ms.     

口腔感染白色念珠菌的基因分型及药敏分析

目的 研究口腔黏膜念珠菌病患者白色念珠菌的基因分型及药敏试验分析.方法 采用聚合酶链反应（PCR）对78株口腔白色念珠菌基因分型,用纸片扩散（K-B）法进行药敏试验,测定白色念珠菌不同基因型对两种临床常用抗真菌药物的敏感性,采用SPSS16.0软件包对数据进行统计分析.结果 口腔念珠菌病患者唾液中分离的白色念珠菌A型占57.7％,B型占26.9％,C型占15.4％.药敏试验结果为：78株白色念珠菌对氟康唑敏感的占89.7％,对伏立康唑敏感的占98.7％,对伏立康唑敏感率高于氟康唑（P＜0.05）.结论 引起口腔黏膜念珠菌病的白色念珠菌基因呈多态性,且不同基因型对抗真菌药物的敏感性存在较大差异,基因分型对口腔念珠菌病的诊断及合理用药有重要意义.     

Morphogenesis of the secondary palate in mouse embryos with special reference to the development of rugae

Morphological studies of secondary palate formation, with special reference to the development of rugae, were carried out on Jcl:ICR mouse embryos. Three rugae were observed on the anterior part of the future oral surface of the vertically developing palatal shelves in 13-day embryos. Rugae increased in number as the development of the palatal shelves proceeded, and five to six prominent rugae were observed in 14-day embryos just prior to shelf elevation. The folding of these five to six rugae progressed in conjunction with the formation of a sharp, valley-like groove at the base of the anterior two-fifths of the vertical palatal shelves. As palatal shelves elevated, the groove disappeared gradually, and, accordingly, the folding of rugae loosened. In the groove region, the superficial epithelial cells were roundish, while the basal ones were elongated. Such characteristic features were no longer observed when the disappearance of the groove was completed. Eight rugae were observed on the future hard palate of 14-day embryos with already completed palatal fusion. An additional ruga was frequently found in 15-day embryos, and the pattern then was almost the same as that of an adult. Epithelial thickening and condensation at the rugae region, as well as mesenchymal condensation under the epithelium of the rugae, were confirmed in embryos both before and after elevation of the palatal shelves. There is a possibility that these structural characteristics observed in the epithelial and mesenchymal cells of the rugae and groove regions may be related to palatal shelf elevation.     

Value of detection of antibodies toCandida albicans germ tube in the diagnosis of systemic candidosis

To test the value of detection of anti-Candida albicans germ tube antibodies by indirect immunofluorescence assay in the diagnosis of systemic candidosis, a retrospective study was done using 126 sera from 27 patients with presumptive systemic candidosis (13 immunocompromised), 165 sera from 45 patients with aspergillosis (29 immunocompromised), 35 sera from eight patients with cryptococcosis (6 immunocompromised), and 101 sera from 101 blood donors. While 21 of 27 patients with systemic candidosis (77.8%) had anti-germ tube antibodies, these antibodies were absent in all patients with cryptococcosis and in all blood donors. They were however detected in 5 of 45 patients with aspergillosis (11.1%). Ten of 13 (76.9%) immunocompromised patients with candidosis had anti-germ tube antibodies; similar results were obtained in immunocompetent patients with candidosis (78.6%). The specificity was 96.8%, indicating a high degree of discrimination was possible between systemic candidosis and other invasive mycoses in the patients studied. Anti-germ tube responses did not appear to be significantly reduced in immunocompromised patients.     

Nucleus ambiguus of the rabbit: Cytoarchitectural subdivision and myotopical and neurotopic representations

The cytoarchitectural subdivisions of the nucleus ambiguus of the rabbit and its myotopical and neurotopical representations were investigated with HRP labeling. The nucleus was subdivided into the compact cell group (CoG), the medial and lateral scattered cell groups (SGm and SGl), and the diffuse cell group (DiG). The CoG was formed by esophageal, pharyngeal constrictor, and palatal motoneurons in the rostral half of the nucleus. The SGm and SGl were located medial and lateral to the CoG, respectively, in the rostral one-third of the nucleus. Stylopharyngeal and cricothyroid motoneurons were located in the most rostral one-fifth of the SGm and the remaining four-fifths, respectively, whereas the SGl was not labeled with HRP injections into the palatal, pharyngeal, esophageal, and laryngeal muscles. The DiG was formed by recurrent laryngeal motoneurons in the caudal two-thirds of the nucleus. Neurons of origin for the glossopharngeal nerve occupied the stylopharyngeal region, with a few of them scattered in the CoG and SGl. Neurons giving rise to axons in the superior laryngeal nerve occupied the cricothyroid region, with a few of them scattered in the pharyngeal constrictor region; whereas the pharyngeal vagal branch originated from the pharyngeal constrictor and palatal regions. Neurons of the DiG, SGl, and esophageal region contributed to the infranodosal vagus nerve; esophageal fibers of the recurrent laryngeal nerve originated from the dorsal esophageal region. Laryngeal fibers of the recurrent laryngeal nerve originated from the DiG, the caudal neurons of which had axons traversing the cranial accessory root. © 1993 Wiley-Liss, Inc.     

Efficacy of antibiotics-loaded interpenetrating network (IPNs) hydrogel based on poly(acrylic acid) and gelatin for treatment of experimental osteomyelitis: in vivo study

The safety and efficacy of gentamycin sulphate (GS)- or vancomycin hydrochloride (VCl)-loaded polymer devices based on poly(acrylic acid) and gelatin crosslinked selectively using 0.3 mol % N,N'-methylene bisacrylamide and 1 wt% glutaraldehyde were evaluated by varying the drug concentration onto the devices. The placebo and drug-loaded device of AxGx (acrylic acid:gelatin: 1:1 w/w) were employed for the treatment of experimental osteomyelitis in rabbit. Rabbits were categorized into four groups. Twelve rabbits in each group were treated with 12+/-1 mg of AxGx-1a (22% w/w GS), 12+/-1 mg of AxGx-1b (44% w/w GS), 16+/-1 mg of AxGx-1b (44% w/w GS) and 16+/-1 mg of AxGx-1c (44% w/w VCl). The drug concentration was measured following implantation in the adjacent tissue of femoral cavity, and serum. In femoral cavity maximum drug concentration was found on the 7th day with all the four types of devices. No drug was found after 21 days, at the local site with devices AxGx-1a and AxGx-1b (12+/-1 mg), whereas it was detected after 6 weeks with 16+/-1 mg device (44% w/w GS or VCl). Macroscopic evaluation after treatment revealed that swelling, redness, local warmth and drainage decreased depending upon the drug loading of the implants. Sequential radiographs, histology, microbiologic assay and scanning electron micrography demonstrated devices AxGx-1b and AxGx-1c (16+/-1 mg of 44% w/w drug loading) to be the most suitable device, which heals the infection after 6 weeks of treatment. No significant difference (p>0.05) in the rate of healing was observed between GS- and VCl-loaded devices. None of the implant showed toxic level of drug in serum at any given time.     

Variations of the prominences of the bony palate and their relationship to complete dentures in Korean skulls.

The osteological and morphological variations of the prominences in the bony palate of 160 Korean skulls were studied. The frequency of the occurrence of the posterior palatine crest, located on the posterior border of the greater palatine foramen, was 13.8%. Palatal ridges were observed commonly in the skulls; however, the smooth type, which has no palatal ridges in the palate, was shown in 14.7% of cases, and palatal spines were observed in 33.8%. The prevalence of palatal tubercles was 11.6%, and all were found in the molar region. The palatine torus was found in 18.8% of cases and the most common type was along the median palatine suture from the incisive foramen to the posterior border of the palatine bone (63.3%). No significant differences between sexes or sides were found in the posterior palatine crest, palatal ridges, and palatal tubercle. However, the sex distribution of the palatine torus was significantly different (P < 0.05). These results would be helpful clinically in fabricating maxillary complete dentures for edentulous patients.     

Human cerebral candidosis — A postmortem evaluation of 19 patients

Candidosis is the most common portmortem cerebral mycosis, yet is rarely appreciated clinically. From 8975 complete autopsies, 41 patients were identified with tissue verified deep candidosis. Nineteen of them (46 per cent) had cerebral candidal infections. There were eight males and 11 females, and 15 whites and four blacks. The ages varied from 17 days to 82 years, with a mean age of 40 years. Cancer was observed in four (21 per cent). All 19 individuals had proven or suspected gram negative sepsis and had been treated with appropriate antibiotic therapy. Other predisposing factors included major surgery (63 per cent), steroid therapy (53 per cent), and deep venous lines (42 per cent). Candida species was identified outside the brain in every patient and included the kidneys (90 per cent), heart (80 per cent), and other organs. Portals of entry appeared to be the gastrointestinal tract, deep venous lines, or both. In this autopsy population, candidosis occurred only in compromised patients and produced intracerebral microabscesses and noncaseating granulomas without diffuse leptomeningitis. Cerebral lesions occurred late in the disease, and were complicated by cardiac and renal candidosis, which contributed to the patient's death. With an increased awareness of the appropriate clinical setting, this iatrogenic mycosis can be handled properly and prevented from jeopardizing the patient.     

The effect of antifungal treatment on the vaginal flora of women with vulvo-vaginal yeast infection with or without bacterial vaginosis

Antibacterial therapy may enhance the risk of symptomatic vulvo-vaginal candidosis in susceptible women. We addressed the question whether oral antifungal treatment for vulvo-vaginal candidosis also influences the bacterial vaginal microflora. One hundred and forty-two patients with a culture-proven acute episode of recurrent vulvo-vaginal candidosis (RVC) were treated with fuconazole according to the ReCiDiF regimen (induction dose of 600 mg orally per week followed by 200 mg per week) or with a single dose of 200 mg pramiconazole, a new potent oral triazole. At inclusion, 1 week and 1 month after the end of antifungal treatment, the bacterial microflora was assessed by microscopy of vaginal fluid to detect lactobacillary grades and bacterial vaginosis (BV). The presence of BV was studied in these patients with vulvo-vaginal candidosis after treatment with antifungal medication. At the start of oral antifungal treatment, 6.3% of women with Candida were co-infected with BV. Of the BV-negative women, 10 out of 133 (8%) developed BV after 1 week and after 1 month 8 of them (7%) were still BV-positive. Although no patients received antibacterial treatment at any moment of the study, 6 out of 9 (66%) of the women with Candida and BV at inclusion no longer had BV 1 week after antifungal treatment and 6 out of 7 (86%) lacked BV after 1 month. Treatment with antifungals may have a beneficial effect on women with concurrent BV, but does not prevent BV from occurring in BV-negative women with Candida vaginitis.     

Angiographic study of the arterial supply to the palatine mucoperiosteum.

Studies on the arterial supply of dog palatal mucoperiosteum have contributed to the success of surgical procedures on the hard palate of humans. We decided to undertake a more detailed anatomical study of the arterial supply of the canine palate. 15 male dogs of the species Canis familiaris were used. Contrast solution (barium sulfate) was injected into the palatal arterial system, followed by the removal of the dog's palate together with its mucoperiosteum. To obtain good radiographic imaging of the arterial network of the palatal mucoperiosteum, decalcification of the palatal bone was carried out. X-ray images were taken by a mammography X-ray machine set for 23 kV and 10 mA. The X-ray images showed that the mucoperiosteal arterial network is composed of a left and a right major artery which enters the mucoperiosteum through the left and right foramen, respectively. Anastomoses were observed between these two major arteries along their path from the posterior to the anterior regions of the mucoperiosteum. These anastomoses always occurred at the palatal transversal crests. The statistical study of the collected data showed that, for the posterior third of the palate, there is a proportionality between the number of the arterial derivations from the two major arteries and the mucoperiosteal area. The X-ray images also showed that the middle third of the palate is the least supplied with arterial derivations.     

Width and elevation of the palatal shelves in unoperated unilateral and bilateral cleft lip and palate patients in the permanent dentition

Patients with cleft left lip and palate (CLP) normally require extensive surgery from an early age up to the end of adolescence. These surgeries affect the growth of the maxillofacial complex. The degree to which the cleft itself affects growth of the maxillofacial complex remains poorly understood. By analysing the width and elevation of the palatal shelves in unoperated adolescents and adults with unilateral and bilateral cleft lip and palate (UCLP and BCLP, respectively) and a non-cleft control group, it is possible to gain more insight into the real intrinsic growth potential of the maxillary structures. In this study, dental casts of the full permanent dentition of individuals with unrepaired UCLP (n = 68) and BCLP (n = 13) and non-cleft controls (n = 24) from the same area of Indonesia were digitized three-dimensionally. Maxillary arch width in the canine, premolar and molar regions, and the width and elevation of the palatal shelves were measured. Results showed that in patients with UCLP, the width of the palatal shelves on the cleft side in all regions, and on the non-cleft side in the canine/first premolar region, was significantly smaller compared with the control group. BCLP subjects showed similar deviations. In the UCLP group, the palatal shelves were rotated cranially and positioned more vertically. In the BCLP group, the palatal shelves were inclined by almost 10 ° more than the control group. The width of the palatal shelf and width of the maxillary arch positively correlated in the canine and first premolar regions for both the cleft and non-cleft side in patients with UCLP, and in the canine region for patients with BCLP. This means that the wider the palatal shelf, the wider the maxillary arch. The elevation of palatal shelves correlated with the maxillary arch width in all regions in patients with UCLP, and only in the premolar region in the control group. Thus, the wider the arch width, the smaller the elevation angle (the maxillary shelves are less vertical). No correlations between palatal shelf elevation and maxillary arch width were found in the BCLP group. This shows that the intrinsic growth potential in patients with UCLP and BCLP is affected by a smaller palatal shelf width and larger elevation of the shelves. These deviations may result in a wider cleft.     

Smad2/3信号分子在小鼠胚胎腭发育和腭裂形成中的表达

背景：部分学者通过体外器官培养研究认为全反式维甲酸干扰了Smad2/3在腭部的表达,具体机制尚不明确。 目的：观察腭突Smad2/3信号分子在胚鼠腭部发育及腭裂形成过程中的表达变化。 方法：54只C57BL/6J近交系孕鼠随机分为3组,在妊娠10 d,实验组一次性灌胃全反式维甲酸100 mg/kg诱导胚鼠两侧腭突不能在中线融合,建立腭裂畸形动物模型;植物油对照组灌胃10 mL/kg橄榄油,空白对照组不做处理。 结果与结论：在植物油对照组中,从妊娠13 d 18时到妊娠14 d 18时腭间充质细胞中Smad2/3免疫阳性表达逐步增高,至妊娠15 d 8时表达开始出现下降,实验组也表现为这一变化趋势,且同一组间表达较植物油对照组明显;在腭中嵴上皮细胞中,植物油对照组随着腭突的融合,腭中嵴上皮带消失,Smad2/3表达也明显下降,实验组始终未融合,未见明显的Smad2/3阳性细胞。在整个胚腭正常发育和腭裂形成过程中,空白对照组与植物油对照组Smad2/3阳性细胞表达几乎无差异。提示过量全反式维甲酸可能通过干扰腭中嵴上皮细胞及间充质细胞中Smad2/3信号分子的表达,从而影响小鼠胚腭上皮间充质转化,与腭裂形成密切相关。     

Bisphosphonate-laden acrylic bone cement: mechanical properties, elution performance, and in vivo activity

Cemented total hip replacements generally fail after 10-20 years, often due to implant loosening from bone resorption. Bisphosphonates such as zoledronic acid (ZA) and pamidronate (PAM) are potent inhibitors of bone resorption. The local delivery of bisphosphonates via acrylic bone cement could decrease osteolysis and prolong implant lifespan. Conflicting studies suggest that bisphosphonate loading may or may not reduce the mechanical properties of acrylic bone cement. We assayed acrylic bone cement laden with ZA or PAM at different concentrations and diluent volumes. Four-point bend testing and compressive testing indicated that high volumes of diluent (with or without bisphosphonate) significantly reduced bending modulus and compressive strength. Radiography and electron microscopy indicated that high diluent volumes generated abnormal acrylic bone cement structure. After 6 weeks of incubation in saline, only 0.9% w/w of the total bisphosphonate incorporated in acrylic bone cement eluted in vitro, indicating a slow elution rate. In vivo testing was performed using a rat model. Cement cylinders were inserted into incisions in rat distal femora and ZA delivered locally (via elution from acrylic bone cement) or systemically (via injection). At 4 weeks postoperatively, dual energy X-ray absorptiometry demonstrated no significant increase in local bone mineral density (BMD) adjacent to ZA-laden implants. In contrast, systemic ZA delivery (0.1 mg/kg) led to a large (48.6%) and significant increase in BMD. Thus, systemic delivery appears more effective than local delivery.     

Emergence of fluconazole-resistant strains of Candida albicans in patients with recurrent oropharyngeal candidosis and human immunodeficiency virus infection.

After repeated use of fluconazole for therapy of oropharyngeal candidosis, the emergence of in vitro fluconazole-resistant Candida albicans isolates (MIC, > or = 25 micrograms/ml) together with oral candidosis unresponsive to oral dosages of up to 400 mg of fluconazole were observed in patients with human immunodeficiency virus (HIV) infection. Antifungal susceptibility testing was done by broth microdilution and agar dilution techniques on C. albicans isolates recovered from a cohort of patients with symptomatic HIV infection who were treated repeatedly with fluconazole for oropharyngeal candidosis. In vitro findings did show a gradual increase in the MICs for C. albicans isolates recovered from selected patients with repeated episodes of oropharyngeal candidosis. Primary resistance of C. albicans to fluconazole was not seen. Cross-resistance in vitro occurred between fluconazole and other azoles (ketoconazole, itraconazole), but to a lesser extent. The results of the study suggest that the development of clinical resistance to fluconazole could be clearly correlated to in vitro resistance to fluconazole. Itraconazole may still serve as an effective antifungal agent in patients with HIV infection and oropharyngeal candidosis nonresponsive to fluconazole.     

Minor salivary gland swelling in patient with Sj?gren's syndrome

A case of Sj?gren's syndrome with an unusual minor salivary gland swelling is reported. The patient was a 63-year-old female with a chief complaint of palatal swelling and dry mouth. Clinical examination revealed diffuse swelling of the hard palate and bilateral parotid regions, and sialographic examination of the parotid gland showed evidence of sialoangiectasia. Histopathological findings of the palatal and parotid lesions revealed intense lymphoid cell infiltration replacing the salivary gland parenchyma, and scattered epimyoepithelial islands throughout the lesions. Although it is well known that major salivary gland swelling caused by marked lymphoid cell infiltration is one of the common features in patients with Sj?gren's syndrome, a similar swelling in the region of the minor salivary glands is not usually apparent.     

Hyaluronic acid and other glycosaminoglycans of the human palatal tonsils

The aim of this study was to determine whether the proportions of individual glycosaminoglycans (GAGs) change with bacterial infection of the human palatal tonsils and after recovery as compared with the physiological state of the palatal tonsils. In tonsillitis the greatest changes were related to hyaluronic acid (decrease) and heparin (increase). In the cured palatal tonsils the content of GAG components was found to return to that of the physiological state of the tonsils. The changes in GAG components in the cured palatal tonsils may possible contribute to the reversal of the human tonsillitis. The supposition is drawn that also physiological function of the cured tonsils is resumed.     

Polydispersity of glycosaminoglycan components in human palatal tonsils

The aim of this study was to characterize glycosaminoglycan components in human palatal tonsils and to determine whether the proportions of individual glycosaminoglycans change with bacterial infection of the palatal tonsils and after recovery. The changes in glycosaminoglycans' content in the course of tonsillitis were mainly related to heparin and chondroitin-4-sulphate (increase) and hyaluronic acid (decrease). After recovery the polydispersity of glycosaminoglycans was found to be comparable to that in normal palatal tonsils.