A trial of amitriptyline and fluphenazine in the treatment of painful diabetic neuropathy

We conducted a double-blind, placebo-controlled, crossover study of the effectiveness of amitriptyline and fluphenazine in alleviating the pain of diabetic peripheral neuropathy in six diabetic patients. Pain was evaluated by the patients with a graphic rating scale. A placebo response was found, but no additional effect of amitriptyline and fluphenazine was seen. Although the statistical power of this study was low, these data, when combined with a reevaluation of previous trials of amitriptyline and fluphenazine in the treatment of painful diabetic neuropathy, indicate that there is no justification for the use of these agents in the treatment of painful neuropathy outside of large, controlled clinical trials. Depression as a possible cause of this condition should not go unnoted or untreated.     

Fracture strength of Class I versus Class II restored premolars tested at the marginal ridge. 2. Cavosurface bonding and cavosurface plus internal enamel bonding

The purpose of this study was to test the difference between the strength of the marginal ridge of extracted teeth with a Class I composite resin restoration and the strength of the marginal ridge of teeth with a Class II amalgam restoration with retention grooves. A statistically significant difference in fracture strengths was found among groups. No statistically significant difference was found among restored preparations, beveling technique, and restorative material. Statistically significant differences in fracture strength were found between the whole tooth group and treatment groups; between the whole tooth group and Class II amalgam restoration group; and between the unrestored tooth preparation group and all other tooth groups.     

Schistosoma mansoni: anti-SMw32 proteinase response in vaccinated and challenged baboons

Antibodies to a cysteinyl proteinase of the trematode Schistosoma mansoni have been detected in serum from infected mice and humans. We have evaluated antiproteinase responses in infected baboons and in baboons vaccinated with irradiated, cryopreserved schistosomules prior to challenge. Prechallenge sera and normal, uninfected control sera were nonreactive by ELISA and immunoblots. Serum antibodies were first detectable by ELISA at two months post-challenge in both challenged (C) and vaccinated-challenged (V-C) baboons (serum dilution 1:200). By four months post-challenge, ELISA absorbance values for subgroup C baboons were significantly higher than for V-C counterparts. The immunoblot technique provided a more sensitive means of detecting antibody early in the infection. One month post-challenge, 7 of 12 C and V-C sera (diluted 1:100) contained measurable anti-proteinase antibody. By month two, 12 of 12 were immunoblot-positive. Baboons vaccinated but not challenged (subgroup V) remained negative. The presence of the anti-proteinase antibody appears to be a sensitive and early marker for infection by S. mansoni.     

N-[(carbamoylmethyl)amino]ethanesulfonic acid improves phenotyping of alpha 1-antitrypsin by isoelectric focusing on agarose gel

The hereditary deficiency variants of alpha 1-antitrypsin that are associated with diseases such as emphysema are usually identified by use of isoelectric focusing on polyacrylamide gels. Agarose is a simpler, faster, safer, and more reliable medium for this, but resolution often is not as good. I describe a method in which the ultrathin agarose gel contains N-[(carbamoylmethyl)amino]ethanesulfonic acid as a "separator," to flatten the pH gradient and improve separation of the alpha 1-antitrypsin isoforms. The resolution obtained equals or surpasses that of conventional methods based on use of either polyacrylamide or agarose. Haptoglobin, which interferes with isoelectric focusing on polyacrylamide, does not interfere with this method; other advantages are also discussed.