A new application of TCE-MEP: spinal cord monitoring in patients with severe neuromuscular weakness undergoing corrective spine surgery

The importance of spinal cord monitoring during corrective scoliosis surgery is widely acknowledged. However, for patients with preoperative neurologic deficits, its use is technically difficult. In this article, we describe intraoperative transcranial electrical motor evoked potential (TCE-MEP) monitoring in nine patients with neuromuscular weakness who underwent corrective scoliosis surgery. In each patient, eight muscle groups were recorded and stable responses were obtained in all patients. We conclude that TCE-MEP permits monitoring of the spinal cord in patients with disturbed motor function.     

Cyclooxygenase-2 is widely expressed in atherosclerotic lesions affecting native and transplanted human coronary arteries and colocalizes with inducible nitric oxide synthase and nitrotyrosine particularly in macrophages

Inflammation appears to have a major role in the development of atherosclerotic lesions affecting native and transplanted coronary arteries. The subsequent risk of plaque rupture and acute ischemic events correlates with the degree of inflammation and may be modified by aspirin, an anti-inflammatory cyclooxygenase inhibitor. Cyclooxygenase-2 (Cox-2) and inducible nitric oxide synthase (iNOS) are involved in the inflammatory response via the rapid and exaggerated production of prostanoids and nitric oxide, both of which may have proatherosclerotic effects. These effects may be mediated by the formation of peroxynitrite in the case of nitric oxide and involve "cross talk" between the two enzyme systems. This study aimed to investigate native and transplant atherosclerosis for the presence and distribution of Cox-2 and iNOS. Immunocytochemical studies were performed on atherosclerotic lesions from patients with native (n=12) and transplant (n=5) coronary disease by using antibodies to Cox-2, iNOS, and nitrotyrosine (an indicator of peroxynitrite production). Control tissue was obtained from unused donor hearts and at the time of autopsy. Cox-2 and iNOS colocalized predominantly in macrophages/foam cells in both types of atherosclerosis. Cox-2 expression was also detected in medial smooth muscle cells and endothelial cells, including those of the vasa vasorum. Nitrotyrosine was found in the same distribution as that of iNOS and was colocalized with Cox-2 in macrophages. Cox-2 and iNOS are coexpressed in native and transplant atherosclerosis, possibly allowing for interaction between the enzymes and suggesting an alternative mechanism for the benefits of aspirin via inhibition of Cox-2 activity.     

Anti-idiotype CEA antibody vaccine breaks immune tolerance

Cytokine-targeted therapies, the first developed being infliximab, may lower the overall cost of Crohn’s disease by improving outcomes and reducing the need for medical interventions. Dr Russell Cohen from the University of Chicago, US, made this statement at a symposium at the 33rd annual meeting of the American Society of Health-System Pharmacists [ Las Vegas, US; December 1998 ]. During the symposium, Dr Cohen and other experts discussed the pathology and management of Crohn’s disease.     

A sensitivity analysis using alternative toxic equivalency factors to estimate U.S. dietary exposures to dioxin-like compounds

EPA recommends sensitivity analyses when applying the toxic equivalency factor (TEF) method to evaluate exposures to dioxin-like compounds (DLCs). Applying the World Health Organization’s (WHO) 2005 TEF values and estimating average U.S. daily dietary intakes of 25 DLCs from eight food categories, we estimate a toxic equivalency (TEQ) intake of 23 pg/day. Among DLCs, PCB 126 (26%) and 1,2,3,7,8-PeCDD (23%) dominate TEQ intakes. Among food categories, milk (14%), other dairy (28%), beef (25%), and seafood (18%) most influenced TEQ intakes. We develop two approaches to estimate alternative TEF values. Based on WHO’s assumption regarding TEF uncertainty, Approach1 estimates upper and lower TEFs for each DLC by multiplying and dividing, respectively, its individual TEF by ± half a log. Based on compiled empirical ranges of relative potency estimates, Approach2 uses percentile values for individual TEFs. Total TEQ intake estimates using the lower and upper TEFs based on Approach1 were 8 and 68 pg TEQ/day, respectively. The 25th and 75th percentile TEFs from Approach2 yielded 12 and 28 pg TEQ/day, respectively. The influential DLCs and food categories remained consistent across alternative TEFs, except at the 90th percentile using Approach2. We highlight the need for developing underlying TEF probability distributions.     

The effectiveness of chemical denture cleansers and ultrasonic device in biofilm removal from complete dentures

Adequate denture hygiene can prevent and treat infection in edentulous patients. They are usually elderly and have difficulty for brushing their teeth.

Objective

This study evaluated the efficacy of complete denture biofilm removal using chemical (alkaline peroxide-effervescent tablets), mechanical (ultrasonic) and combined (association of the effervescent and ultrasonic) methods.

Material and Methods

Eighty complete denture wearers participated in the experiment for 21 days. They were distributed into 4 groups (n=20): (1) Brushing with water (Control); (2) Effervescent tablets (Corega Tabs); (3) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (4) Association of effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush (Bitufo) and water, 3 times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. To quantify the biofilm, the internal surfaces of the maxillary complete dentures were stained and photographed at 45º. The photographs were processed and the areas (total internal surface stained with biofilm) quantified (Image Tool 2.02). The percentage of the biofilm was calculated by the ratio between the biofilm area multiplied by 100 and the total area of the internal surface of the maxillary complete denture.

Results

The Kruskal-Wallis test was used for comparison among groups followed by the Dunn multiple-comparison test. All tests were performed respecting a significance level of 0.05. Significant difference was found among the treatments (KW=21.18; P<0.001), the mean ranks for the treatments and results for Dunn multiple comparison test were: Control (60.9); Chemical (37.2); Mechanical (35.2) and Combined (29.1).

Conclusion

The experimental methods were equally effective regarding the ability to remove biofilm and were superior to the control method (brushing with water). Immersion in alkaline peroxide and ultrasonic vibration can be used as auxiliary agents for cleaning complete dentures.     

Preferential release of newly synthesized 3H-acetylcholine from rat cerebral cortex slices in vitro

1. Slices of rat cerebral cortex after treatment with the irreversible cholinesterase inhibitor soman, were incubated for 5 min in a Krebs-Henseleit solution containing 25 mM KCl and (3)H-choline. Subsequently incubation was continued in a medium containing non-radioactive choline and this medium was replaced at 5 min intervals. The amounts of labelled and total acetylcholine (ACh) released into the medium and extracted from the slices were determined at intervals.2. After the initial 5 min contact with (3)H-choline, 44% of the newly synthesized ACh contained a choline moiety originating from the choline in the medium. During the initial 5 min and the subsequent incubation part of the labelled ACh was released. While the rate of total ACh release remained constant, that of the release of labelled ACh was highest in the 5 min period following the initial incubation with (3)H-choline and then declined exponentially.3. The ratio of labelled ACh/total ACh in the ACh released during the initial 5 min incubation with (3)H-choline and during the subsequent 5 min was about three times as high as that in the ACh extracted from the slices at the end of these incubation periods.4. The ratio of labelled ACh/total ACh in superficial layers of the slices was not higher than that in the total slices.5. The rates of release of labelled and unlabelled ACh decreased when calcium was omitted from the incubation medium and were restored when the calcium was added. This suggests that both labelled and unlabelled ACh were released from nerve endings. The efflux of (3)H-choline was not calcium dependent.6. It is concluded that labelled ACh newly synthesized from externally applied (3)H-choline does not exchange immediately with all other ACh in the tissue and has a greater chance of being released than unlabelled ACh.     

Elevated lipoprotein(a) as a new risk factor of cerebral venous sinus thrombosis: association with fibrin clot properties

Journal of Thrombosis and Thrombolysis - Elevated lipoprotein(a) [Lp(a)] has been reported to be associated with prothrombotic clot phenotype. We hypothesized that increased Lp(a) contributes to...