DL-Serine: promoting activity on renal tumorigenesis by N-ethyl-N-hydroxyethylnitrosamine in rats

Subcutaneous injection of DL-serine increased the number and size of renal tubular cell tumors in male W rats treated with 500 or 1,000 ppm N-ethyl-N-hydroxyethylnitrosamine [(EHEN) CAS: 13147-25-6, 2-(ethylnitrosamino)ethanol]. At the end of the 32-week experiment, the incidences of renal tumors were 95% in rats treated with 1,000 ppm EHEN for 2 weeks and then given three sc injections of DL-serine every 2 weeks, 33% in rats treated with 1,000 ppm EHEN for 2 weeks, and 28% in rats treated with 500 ppm EHEN for 2 weeks and then given three sc injections of DL-serine every 2 weeks. No renal tumors were found in rats treated with 500 ppm EHEN alone or given three sc injections of DL-serine alone every 2 weeks.     

Association between unmet needs for medication support and all-cause hospitalization in community-dwelling disabled elderly people

OBJECTIVES: To clarify the association between unmet medication management need and 3-year mortality and hospitalization for community-dwelling older people with various levels of disabilities.
DESIGN: Prospective cohort study (the Nagoya Longitudinal Study for Frail Elderly).
SETTING: Community-based.
PARTICIPANTS: One thousand seven hundred seventy-two community-dwelling elderly subjects (611 men, 1,161 women).
MEASUREMENTS: Data included the clients' demographic characteristics, a rating for basic and instrumental activities of daily living (ADLs), number of prescribed medications and physician-diagnosed chronic diseases, medication adherence, ability to manage medication, and presence or absence of medication assistance. Cox proportional hazard models and the Kaplan-Meier method were used to assess the association between the medication management at baseline and mortality or hospitalization during a 3-year period.
RESULTS: Of 1,772 participants, 681 reported no difficulty with self-medication management, and 1,091 experienced difficulty with self-medication. Of participants with difficulty with self-medication management, 929 had medication assistance, and 162 did not. During a 3-year follow up, 424 participants died, and 758 were admitted to hospitals. The baseline data demonstrated that participants not receiving medication assistance were younger and had better ADL status and fewer comorbidities. Multivariate Cox regression models adjusting for potential confounders showed that the lack of assistance in those who needed medication assistance was associated with hospitalization but not mortality during the study period.
CONCLUSION: In community-dwelling disabled elderly people, lack of medication assistance in those needing medication support was associated with higher risk of hospitalization.     

Pulmonary hemorrhage associated with Henoch-Schönlein purpura in a child

Swelling of the right ankle and purpura on the bilateral lower extremities of a 6-year-old boy indicated a diagnosis of Henoch-Schönlein purpura (HSP). The patient was referred to our hospital because of severe abdominal pain that was unresponsive to prednisolone. Respiratory symptoms and pulmonary infiltrates on chest X-ray were absent upon admission. Methylprednisolone pulse therapy gradually improved the abdominal symptoms, but tachypnea developed, and insufficient aeration of the right lung was accompanied by a decline in percutaneous oxygen saturation from 99% to 90% and a rapid decrease in hemoglobin levels from 11.7 to 7.6 g/dL. Chest X-rays and high-resolution computed tomography scans showed widespread consolidation and patchy opacities predominantly in the right lung fields, suggesting acute pulmonary hemorrhage. Intravenous cyclosporin A (CyA) gradually resolved the pulmonary hemorrhage and respiratory insufficiency. Pulmonary hemorrhage, as a complication of HSP, is extremely rare and sometimes fatal. Aggressive steroid and immunosuppressive treatment is required to address severe complications of HSP.     

Anticariogenic effect of fluoride-releasing elastomers in orthodontic patients

This in vivo experimental study evaluated the efficacy of fluoride-releasing elastomers in the control of Streptococcus mutans levels in the oral cavity. Forty orthodontic patients were recruited and divided into two groups of 20. Fluoride-releasing elastomeric ligature ties (Fluor-I-Ties, Ortho Arch Co. Inc., USA) were used in the experimental group, and conventional elastomeric ligature ties (D. Morelli, Brazil), in the control group. Two initial samples of saliva were collected at a 14-day interval to determine the number of colony forming units (CFU) of Streptococcus mutans. Immediately after collecting the second sample, fluoride-releasing elastomeric ligature ties were placed in the patients of the experimental group, and conventional ligature ties, in the patients of the control group. Seven, 14 and 28 days after placement of the elastomeric ligature ties, saliva and plaque surrounding the orthodontic appliance were collected for microbiologic analysis. There were no significant differences in the number of Streptococcus mutans CFUs in saliva or plaque in the area surrounding the fluoride-releasing or conventional elastomeric ligature ties. Thus, fluoride-releasing elastomeric ligature ties should not be indicated to reduce the incidence of enamel decalcification in orthodontic patients. Since there was no significant reduction in S. mutans in saliva or plaque, other means of prevention against enamel decalcification should be indicated for these patients.     

Does rapid maxillary expansion increase nasopharyngeal space and improve nasal airway resistance?

Objective

To evaluate the effect of rapid maxillary expansion (RME) on the dimension of the nasopharyngeal space and its relation to nasal airway resistance.

Methods

Twenty-five school-age children (from 7 to 10 year-old) with mouth and/or mixed breathing, with mixed dentition and uni- or bilateral posterior crossbite involving the deciduous canines and the first permanent molars, were evaluated. RME was placed and remained during 90 days. Rhinomanometry and orthodontic documentation were performed at four different times, i.e., before (T₁), immediately after (T₂), 90 days (T₃) and 30 months (T₄) after RME.

Results

Differences in nasopharyngeal area and in nasal airway resistance were observed only 30 months after RME, and could be explained by facial growth, and not because of the orthodontic procedure.

Conclusion

RME does not influence on nasopharyngeal area or nasal airway resistance in long-term evaluation.     

Congenital segmental dilatation of the duodenum: Report of a case

We herein report what, to our knowledge, is only the fourth known case of segmental dilatation of the duodenum. Antenatal ultrasonography revealed an intraabdominal cyst in the fetus, but the exact location of the segmental dilatation was difficult to find preoperatively. Moreover, even using computed tomography, it was not possible to make a diagnosis prior to surgery. The anatomic characteristics of duodenal dilatation made it difficult to perform the usual resection techniques. In fact, the surgical procedure was different from the previously reported cases. We performed a partial resection of the duodenum followed by a tapering procedure to preserve the ampulla of Vater. The infant had an uneventful postoperative course, and sufficient growth and development has been achieved.