A sudden increase in plasma epinephrine levels transiently enhances platelet deposition on severely damaged arterial wall--studies in a porcine model

Epidemiologic evidence has shown that sympathoadrenal activation plays a triggering role in the onset of acute coronary syndromes. However, its mechanism is not yet clearly understood. The aim of this study was to assess the effect of a sudden increase in epinephrine on platelet deposition on severely damaged vessel wall at shear rate conditions modelling stenotic vessels in the porcine model. The selected epinephrine concentrations (0.5 micromol/l-1 mmol/l) alone or in combination with collagen or ADP did not affect platelet aggregation in vitro either in whole blood or in PRP, although porcine platelets express alpha2-adrenergic receptors as assessed by PCR. In vitro and ex vivo perfusion experiments were performed using the Badimon chamber at high shear rate conditions (1690 s(-1)). In vitro, epinephrine (130 nmol/l) increased platelet deposition on severely damaged vessel wall (exposing tunica media; approximately 1.6-fold, p <0.05) or immobilized collagen (2.2-fold, p <0.01). Ex vivo perfusion experiments were performed from animals that received intravenous epinephrine infusion for one hour at a low (0.3 microg/kg/min; approximately 17 nmol/l in plasma, at 20 min of the infusion) and a high dose (1.0 microg/kg/min; approximately 106 nmol/l in plasma, at 20 min of the infusion). Only the low dose temporarily increased platelet deposition on severely damaged vessel wall during the first 30 min of infusion [2.4-fold (p <0.05) and 4.2-fold (p <0.01) at 10 and 30 min of the infusion respectively] declining afterwards. Thus, in flow conditions typical of atherosclerotic arteries, a sudden physiological release of epinephrine can temporarily enhance platelet deposition on severely damaged vessel wall while an extensive exposure leads to refractoriness.     

Synthesis and characterization of new dimethacrylate monomer and its application in dental resin

In this study, a dimethacrylate monomer, 1,4-Bis[2-(4-(2′-hydroxy-3′-methacryloyloxy-propoxy)phenyl)-2propyl]benzene (BMPPB) was synthesized to replace 2,2-bis[4-(2′-hydroxyl-3′-methacryloyloxy-propoxy)phenyl]propane (Bis-GMA) as one component of dental restorative materials. The structure of BMPPB and its intermediate product 1,4-bis[2-(4-(oxiranylmethoxy)phenyl)-2propyl]benzene (BOPPB) were confirmed by Fourier transform infrared (FTIR) spectroscopy, proton nuclear magnetic resonance spectroscopy (¹H-NMR), and elemental analysis. In order to evaluate the possibility of replacing Bis-GMA with BMPPB in dental resin, double bond conversion (DC), polymerization shrinkage, contact angle, water sorption (WS) and solubility (SL), and flexural strength (FS) and modulus of BMPPB/tri(ethylene glycol)dimethacrylate (TEGDMA) (50/50?wt) resin system and Bis-GMA/BMPPB/TEGDMA (25/25/50?wt) resin system were studied. Commercially used Bis-GMA/TEGDMA (50/50?wt) dental resin system was used as reference. The results showed that BMPPB-contained copolymer had higher DC, higher WS and SL than the copolymer that only contained Bis-GMA (p?<?0.05). All of the copolymers had nearly the same contact angle (p?>?0.05). BMPPB/TEGDMA resin system had lower polymerization shrinkage, higher FS and modulus (p?<?0.05) than Bis-GMA/TEGDMA resin system. There was no significant difference on polymerization shrinkage, FS and modulus (p?>?0.05) between Bis-GMA/BMPPB/TEGDMA resin system and Bis-GMA/TEGDMA resin system. Before and after water immersion, both FS and modulus of every copolymer did not change significantly (p?>?0.05). Therefore, BMPPB had potential to be used to replace Bis-GMA as base resin in dental restorative materials, but many studies should be undertaken further.     

Fatigue failure load of immature anterior teeth: influence of different fiber post-core systems

Odontology - The aim was to explore the fracture-behavior, survival and marginal-microgaps within the root-canal of immature anterior teeth restored with different fiber-reinforced post-core...     

Active online assessment of patients using new oral anticoagulants: bleeding risk, compliance, and coagulation analysis

Clinicians prescribing new oral anticoagulants (OACs; dabigatran, rivaroxaban, and apixaban) should be aware of the exclusion criteria related to bleeding risks defined in published clinical studies. At least a quarter of patients currently using warfarin have an exclusion criterion that may prevent easy transition to the new OACs. In the summary of product characteristics for dabigatran, as an example, the target populations appear generalized. Due to fixed dosing and predictable pharmacology, routine laboratory monitoring of new OACs is deemed unnecessary. Under special circumstances, however, understanding the extent of thrombin or factor (F) Xa inhibition may aid in evaluating compliance and handling emergency interventions, bleeding complications, or overdoses. Although commonly available global coagulation-time assessments (prothrombin time and activated partial thromboplastin time) are insensitive, they may assist clinical management by indicating a severe accumulation of OACs; moreover, a normal thrombin time (TT) excludes a thrombin-inhibitor effect. In particular circumstances, specific assays (diluted TT, Ecarin clotting time, anti-FIIa or anti-FXa activity) may quantify the anticoagulant effect, but therapeutic ranges for dose adjustment are not yet established. Laboratory results are also influenced by clinical situation: e.g. bleed (consumption of coagulation factors) versus postoperative state (activation of coagulation). Without specific antidotes and evidence-based treatment strategies, new OACs are clinically worrisome in patients with impaired renal or liver function. Postmarketing surveillance and recording of bleeding complications (ICD-10 D68.32) are therefore of major importance.     

Single visit replacement of maxillary canine using fiber-reinforced composite resin

Missing a canine is of serious concern in social life of a patient in most of societies. While conventional fixed partial dentures and implant-supported restorations may often be the treatment of choice, fiber-reinforced composite (FRC) resins offer a conservative, fast and cost-effective alternative for single and multiple teeth replacement. This clinical report presents two cases where FRC technology was successfully used to restore canine edentulous area in terms of esthetic-cosmetic values and functionality.     

Characterization of a new fiber-reinforced flowable composite

Odontology - This study aimed to evaluate certain physical properties including surface wear of a new experimental short fiber-reinforced flowable resin composite (SFRC) in comparison with...     

Atipamezole, an imidazoline-type alpha(2)-adrenoceptor inhibitor, binds to human platelets and inhibits their adrenaline-induced aggregation more effectively than yohimbine

To investigate the usefulness of atipamezole [MPV-1248, 4-(2-ethyl-2, 3-dihydro-1H-inden-2-yl)-1H-imidazole], a novel alpha(2)-adrenoceptor-specific antagonist, as a tool in platelet studies, the ability of this antagonist: (1) to bind to platelet alpha(2)-adrenoceptors, and (2) to inhibit adrenaline-induced platelet aggregation was compared to that of yohimbine, another commonly used alpha(2)-adrenoceptor antagonist. It was found that atipamezole binds to platelet alpha(2)-adrenoceptors more effectively than yohimbine: [3H]atipamezole has more than three times higher alpha(2)-adrenoceptor binding affinity in intact gel-filtered human platelets (equilibrium dissociation constant (K(d)) 0.7+/-0.21 vs. 2.9+/-0.77 nM, p<0.05), but only one-third of the binding capacity of [3H]yohimbine (B(max) 27.0+/-3.8 vs. 100+/-19 pM/10(5) cells, p<0.01). Functionally, in comparison with yohimbine, an almost threefold lower concentration of atipamezole inhibited adrenaline (5 microM)-induced platelet aggregation. A concentration of atipamezole, which inhibited this aggregation by 50% (IC(50)), was 0.37+/-0.07 microM, whereas IC(50) for yohimbine was 0.98+/-0.12 microM, p<0.0001. Thus, atipamezole represents a functionally undisputed alpha(2)-adrenoceptor antagonist, more effective than yohimbine. Its distinct binding profile as a radioligand also suggests the presence of imidazol(in)e binding sites in platelets.