Influence of oral hygiene on the mucosal conditions beneath bridge pontics

Abstract – The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index, Daily use of dental floss resulted in a significantly lower number of microorganisms per mm² compared with the other hygienic measures, Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inEammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a, part of the oral hygiene regimen in patients wearing fixed bridges.     

Biliary Cystadenoma of the Common Bile Duct with Secondary Biliary Cirrhosis

Abstract A case of cystadenoma of the common bile duct is described. An erroneous diagnosis made in a young woman caused secondary biliary cirrhosis with fatal outcome. The diagnosis of cirrhosis should never be established without thorough visualization of the entire biliary tract in patients with biochemical or clinical jaundice of unknown origin.     

Discoid lupus erythematosus-like lesions and stomatitis in female carriers of X-linked chronic granulomatous disease

The skin and oral mucosa were studied in an unselected series of carriers of X-linked chronic granulomatous disease, a hereditary condition in which phagocytic cells display a pronounced functional defect. Three carriers had discoid lupus erythematosus (DLE)-like skin lesions which histopathologically were consistent with DLE of the hypertrophic and profundus type. Four patients had experienced photosensitivity in childhood. Seven patients had recurrent aphthous-like stomatitis which should be distinguished from the recurrent aphthous stomatitis seen in otherwise healthy individuals. The remarkably high incidence of DLE-like symptoms in heterozygous carriers might be related to the presence of mixed populations of defective and normal phagocytes. The variable expression of skin symptoms may be related to uneven distribution of abnormal to normal phagocytes. Female patients with these clinical symptoms, especially the combination of DLE-like skin lesions and aphthous-like stomatitis, should be suspected of being carriers of chronic granulomatous disease and studies of phagocyte function in vitro should be performed, since the diagnosis of the carrier state is of utmost importance for genetic counselling before pregnancy. In order to describe in greater detail the clinicopathological findings and their frequency of expression in the skin and oral mucosa, we have undertaken a prospective study of nine unselected known carriers of X-linked CGD.     

Normal Myocardial Enzymes and Normal Echocardiographic Findings During Noninvasive Transcutaneous Pacing

Noninvasive transcutaneous pacing was performed for 30 minutes in 10 healthy volunteers. The pace rate was from 85 to 115 min-1, and the threshold for pacing was from 38 to 70 mA, median 59 mA. Echocardiography before and during pacing showed no changes in left ventricular end-diastolic diameter, in fractional shortening nor in contraction pattern. Also, blood pressure remained unchanged. Blood samples for determination of myoglobin, creatine phosphokinase, creatine kinase MB and lactate dehydrogenase were drawn prior to pacing and 1,2,3,4,6,8 and 24 hours after pacing. The serum concentrations were the same before and after pacing for all enzymes and myoglobin. We conclude that non-invasive transcutaneous pacing for 30 minutes causes no muscular or myocardial injury and that the left ventricular function remains normal.     

PREVALENCE OF ALCOHOL PROBLEMS AMONG ADULT SOMATIC IN-PATIENTS OF A COPENHAGEN HOSPITAL

The adult patients of somatic departments of a Copenhagen hospitalwere screened on a randomly selected day during a 14 day periodby interviewers who examined them using a stnictured questionnaireregarding life-style. A patient was considered having an alcoholproblem if one or more of the following criteria was fulfilled:(1) a self-reported daily alcohol consumption for at least 2years of at least 60 g of ethanol in men and 36 g in women,(2) a Michigan Alcoholism Screening Test (MAST) score of orabove 5, (3) an alcohol-related discharge diagnosis. In total,692 patients fulfilled the enny critena, but 181 patients (26.2%)had to be excluded owing to predeflned exclusion criteria (terminalillness, dementia, etc.), and 74 patients (14.5%) refused toparticipate. Among the 437 interviewed patients, 125 patients(28.6%; 95%-confidence limits 24.4–33.1%) fulfilled oneor more of the diagnostic criteria for an alcohol problem. Only14 patients (3.2%; 95%-confidence limits 1.8–5.3%) hadan alcohol-related discharge diagnosis. The prevalence of patientswith alcohol problems was significantly (P < 0.05) higheramong male patients (82 of 171 men (48.0%; 95%-confidence limits40.3–55.7%)) than among female patients (43 of 266 women(16.2%; 95%-confidence limits 12.0–21.2%)). The prevalenceof patients with alcohol problems was 32.4% (95%-confidencelimits 25.5–39.8%) in internal medicine departments, 28.5%(95%-confidence limits 21.3–36.6%) in surgical departments,and of female patients 22.2% (95%-confidence limits 13.7–32.8%)in the department of gynaecology and obstetrics.     

ON INDICATIONS FOR TREATMENT OF THE HYPERPHENYLALANINEMIC NEONATE

Abstract. Of 488 006 neonates tested by Guthrie screening 58 showed values above 2.5 mg/100 ml. Thirty-two showed values between 2.5 nig/100 ml and 15 mg/100 ml. Eighteen of these infants appeared to have phenylketonuria (PKU) and fourteen to have persistent hyperphenylalaninemia (HPA). Neither the initial Guthrie test-value nor the confirmatory test were able to differentiate between these two conditions. Consequently a phenylalanine restricted diet is started in any child with serumphenylalanine values exceeding 10 mg/100 ml (605 μmol/1). The data show that the course of the dietary tolerance of phenylalanine and a 24-hour phenylalanine load test will differentiate infants with PKU from those with HPA.     

Comparative Hepatotoxicity of Two Polychlorotrifluoroethylenes (3.1 Oils) and Two Chlorotrifluoroethylene (CTFE) Oligomers in Male Fischer 344 Rats

Comparative Hepatotoxicity of Two Polychlorotrifluoroethylenes(3.1 Oils) and Two Chlorotrifluoroethylene (CTFE) Oligomersin Male Fischer 344 Rats. DELRASO, N. J., GODIN, C. S., JONES,C. E., WALL, H. G., MATTIE, D. R., AND FLEMMING, C. D. (1991).Fundam. Appl. Toxicol. 17, 550–562. Polychlorotrifluoroethylene(3.1 oil) is a nonflammable hydraulic fluid composed of chlorotrifluoroethylene(CTFE) oligomers of different carbon chain lengths (C5 to C9),primarily six (trimer) and eight (tetramer) carbons. Four testgroups of Fischer 344 rats(l6 rats/group) were orally gavageddaily over a 2-week period at doses of 1.25 g/kg with 3.1 oilcontaining a 55:45 ratio of trimer and tetramer(3.1 oil-C₆:C₃),3.1 oil composed of 95% trimer (3.1 oil-C₆), pure tetramer,and pure trimer. Four rats per treatment group were terminatedafter 1, 3, 7, and 14 doses. Rats dosed with either 3.1 oil-C₆:C³or pure tetramer demonstrated significant weight losses, increasedliver weights, increased rates of liver fatty acid ß-oxidation,pronounced hepatomegaly and altered hepatocellular architecture,and elevated serum liver-associated enzymes. Rats dosed witheither 3.1 oil-C₆ or only pure trimer demonstrated significantincrease in liver weight and moderate liver histopathologicchanges. Compositional analyses of the ratio percentage of trimerto tetramer present in 3.1 oil-C₆:C₃ (55:45) were found to bealtered when measured in the liver (32:68). Differential CTFEoligomer toxicity was indicated by effects on liver, body weight,and peroxisomal ß-oxidation and may allow for lesstoxic formulations of 3.1 oil to be generated by reducing oreliminating the tetramer component.