Does 2 years’ nocturnal treatment with a mandibular advancement splint in adult patients with snoring and OSAS cause a change in the posture of the mandible?

The aim of this pilot study was to investigate the effects of 2 years' nocturnal treatment with a mandibular advancement splint in adult patients with snoring and obstructive sleep apnea syndrome with respect to possible development of a forward position of the mandible or other dentofacial changes. Thirty snoring and sleep apnea patients, mean age 55.3 years (SD, 8.61; range, 46.5 to 79.8 years), referred from the Ear, Nose, and Throat Department, were treated with an acrylic splint with full tooth coverage that advanced the mandible 5 to 8 mm (70% of maximal protrusion) and used 5 mm opening vertically. The splint was used 6 to 8 hours per night and 5 to 7 nights per week. Two lateral head radiographs were taken in centric occlusion, 1 before and 1 after 2 years of treatment. A small but statistically significant forward and downward change in mandibular position was found after treatment; mean was 0.4 mm (SD, 0.53; range, 0.0 to 2.0 mm; P <.001) and 0.3 mm (SD, 0.43; range, 0. 0 to 1.5 mm; P <.001), respectively. The forward and downward movement of the mandible was accomplished by a statistically significant increase in mandibular length-mean was 0.4 mm (SD, 0.62; range, 0.0 to 2.5 mm; P <.01)-and a significant decrease in overjet (P <.001) and overbite (P <.05). However, none of the patients reported any permanent sense of altered occlusion, and the anteroposterior distance between habitual occlusion (intercuspal position) and centric relation (retruded position) did not exceed 1. 0 mm in any of the patients either before or after the treatment. The change in mandibular position might be a result of a condylar and/or glenoid fossa remodeling or condylar position changes within the fossa as a compensatory reaction to the advancement of the mandible (bite jumping). However, to visualize and analyze such possible changes in detail, additional studies using lateral tomography of the temporomandibular joints or magnetic resonance imaging are required. Furthermore, because the treatment of snoring and OSAS patients is considered to be lifelong, long-term studies are needed to analyze if the small change in mandibular position will continue with further treatment.     

Effect of Splenectomy and Autologous Spleen Transplantation on the Serum Platelet-Activating Factor Acetylhydrolase (PAF-AH) Activity and Acute Phase Response (APR) in a Porcine Model

The aim of this study was to evaluate the inflammatory response after total splenectomy and spleen autotransplantation in a porcine model by measuring serum platelet-activating factor acetylhydrolase activity, C-reactive protein and albumin concentrations. Nineteen piglets were used in the experiment. After induction of anesthesia, animals were randomly divided into three groups: sham-operation with spleens intact (n = 6), total splenectomy (n = 6), and splenic autotransplantation (n = 7) with small fragments of the spleen autotransplanted into the greater omentum. The blood samples were taken just before surgery and on day 1st, 5th, 12th, 26th and 40th postoperatively. PAF-AH activity, CRP and albumin concentrations were assayed in the sera. After total splenectomy, PAF-AH activity was significantly increased on day 5th, while there was no significant increase after spleen autotransplantation or the sham-operation. CRP was significantly increased after surgery in all experimental groups. Albumin was significantly decreased after surgery from day 5th until day 40th in splenectomized and autotransplanted pigs. Increased PAF-AH activity after splenectomy and spleen autotransplantation might be attributed to inflammatory conditions due to the loss of splenic tissue and trauma. Time-course increase of CRP, in all groups after surgery suggests post-injury inflammatory response due to tissue lesion during operation.     

High prevalence of middle cerebral artery calcification is associated with cardiovascular mortality in hemodialyzed patients: an overlooked part of arterial tree?

International Urology and Nephrology - We have analyzed markers of accelerated atherosclerosis like large artery stiffness, ankle-brachial index, carotid and vertebral duplex ultrasonography and...     

Molecular structure and chromosome distribution of three repetitive DNA families in Anemone hortensis L. (Ranunculaceae)

The structure, abundance and location of repetitive DNA sequences on chromosomes can characterize the nature of higher plant genomes. Here we report on three new repeat DNA families isolated from Anemone hortensis L.; (i) AhTR1, a family of satellite DNA (stDNA) composed of a 554–561 bp long EcoRV monomer; (ii) AhTR2, a stDNA family composed of a 743 bp long HindIII monomer and; (iii) AhDR, a repeat family composed of a 945 bp long HindIII fragment that exhibits some sequence similarity to Ty3/gypsy-like retroelements. Fluorescence in-situ hybridization (FISH) to metaphase chromosomes of A. hortensis (2n = 16) revealed that both AhTR1 and AhTR2 sequences co-localized with DAPI-positive AT-rich heterochromatic regions. AhTR1 sequences occur at intercalary DAPI bands while AhTR2 sequences occur at 8–10 terminally located heterochromatic blocks. In contrast AhDR sequences are dispersed over all chromosomes as expected of a Ty3/gypsy-like element. AhTR2 and AhTR1 repeat families include polyA- and polyT-tracks, AT/TA-motifs and a pentanucleotide sequence (CAAAA) that may have consequences for chromatin packing and sequence homogeneity. AhTR2 repeats also contain TTTAGGG motifs and degenerate variants. We suggest that they arose by interspersion of telomeric repeats with subtelomeric repeats, before hybrid unit(s) amplified through the heterochromatic domain. The three repetitive DNA families together occupy ∼10% of the A. hortensis genome. Comparative analyses of eight Anemone species revealed that the divergence of the A. hortensis genome was accompanied by considerable modification and/or amplification of repeats. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Development and Validation of Quality Indicators for Dementia Diagnosis and Management in a Primary Care Setting

OBJECTIVES: To construct a set of quality indicators (QIs) for dementia diagnosis and management in a primary care setting. DESIGN: RAND modified Delphi method, including a postal survey, a stakeholders consensus meeting, a scientific expert consensus meeting, and a demonstration project. SETTING: Primary care. PARTICIPANTS: General practitioners (GPs), primary care nurses (PCNs), and informal caregivers (ICs) in postal survey and stakeholders consensus meeting. Eight national dementia experts in scientific consensus meeting. Thirteen GPs in the demonstration project. MEASUREMENTS: Mean face validity and feasibility scores. Compliance rates using GPs' electronic medical record data. RESULTS: The initial set consisted of 31 QIs. Most indicators showed moderate or good face validity and feasibility scores. Consensus panels reduced the preliminary set used in the demonstration project to 24 QIs. The overall compliance to the QIs was 45.3%. Discriminative validity of the set was good; significant differences in adherence were found between GPs with high and low levels of patients aged 65 and older in their practice, with and without PCNs, and with positive and negative attitudes toward dementia (all P<.05). Based on the demonstration project, one QI was excluded. The final set consisted of 23 QIs; 15 QIs contained innovative quality criteria on collaboration between GPs and PCNs, referral criteria, and assessment of caregivers' needs. CONCLUSION: This new set of dementia QIs is feasible, reliable, and valid and can be used to improve primary dementia care. Because of the innovative quality criteria, the set is complementary to the existing dementia QIs.     

Kinetic and mechanistic study of hydroxyl ion electrosorption at the Pt(111) surface in alkaline media

The adsorption of OH^? ions on the Pt(111) plane has been studied by fast cyclic voltammetry in sodium hydroxide solutions (0.03 to 1 M), under quasi-equilibrium and Tafel approximation conditions. It was shown that the OH^? ion adsorption is an electrosorption process with one electron exchanged between an OH^? ion and the platinum surface. The electrosorption process follows the Frumkin adsorption isotherm with low intensity repulsive interactions of the adsorbed species (f=2–3). The estimated values of the standard electrochemical rate constant (k°=5.6×10^?4 cm s^?1) and the standard exchange current density (j^o_o=5.45×10^?2 A cm^?2) indicate a rather fast electrochemical process.