Retromolar foramen: a mandibular variant important to dentistry

The retromolar foramen (RMF) was found to occur in eighteen of 234 adult human mandibles studied (7.7%). No statistically significant difference was found between left and right sides or between sexes. A statistical correlation was made between the occurrence of the RMF and accessory mandibular foramina, accessory mental foramina, mandibular third molars, and three-rooted mandibular first molars. Only the accessory mandibular foramen showed a significant positive correlation with RMF regarding same-side occurrence. Three-rooted first molars were not found in any of the mandibles studied. Due to the relatively frequent occurrence of RMF, it is important for the dental practitioner to be aware of this variant and the possible complications which may occur during the administration of anesthesia and surgical procedures in the region.     

Mechanistic studies of the phototoxic potential of PD 117596, a quinolone antibacterial compound.

PD 117596 is a novel quinolone compound that is being investigated for use as an antibacterial agent. Early investigations demonstrated a significant phototoxic liability associated with this compound. These studies were undertaken to investigate the mechanism of phototoxicity using an in vitro model. In the UVA region, PD 117596 was found to be a more efficient producer of singlet oxygen than rose bengal, ciprofloxacin, nalidixic acid, or PD 118879, another quinolone under investigation. The quantum yield of photoreaction for PD 117596 was relatively low (phi = 0.021); however, it was approximately 10-fold higher than other tested quinolones. In vitro studies using a mouse erythrocyte model were used to further investigate the mechanism of phototoxicity. PD 117596-induced photohemolysis was found to be oxygen dependent with a relatively rapid onset that progressed even after removal of light. Preirradiation of the compound prevented subsequent hemolytic or photohemolytic action. BHA, BHT, alpha-tocopherol, and the iron chelator DTPA were all found to be effective at ameliorating the photohemolytic response. The photohemolytic response was markedly enhanced when D2O was substituted for H2O in the incubation medium, indicating a singlet oxygen-mediated mechanism of action. A rise in thiobarbituric acid products was noted within 1 hr of irradiation and was maximal at the time of onset of overt photohemolysis. These data suggest that singlet oxygen production by irradiated PD 117596 is responsible for secondary changes in mouse red blood cells including lipid peroxidation and ultimately results in cellular lysis.     

Routinegastrostomie in der Behandlung der Ösophagusatresie — notwendig oder nicht?

Ohne Zusammenfassung     

Normal expression of myosin fast alkali light chain 3 in the hindlimb muscle of chick embryos paralyzed with curare

We have used a monoclonal antibody (Mab) raised against the fast alkali light chains of quail pectoral muscle myosin to study the expression of MLC1f and MLC3f in the hindlimb muscle of a staged series of control chick embryos and 16-day embryos that had been paralyzed with curare. The Mab (QBM-2) is highly specific for the fast myosin alkali light chains of chick, hamster, and human muscle myosin. On Western blots, MLC1f is detected in hindlimb actomyosin at all of the stages examined, whereas MLC3f cannot be detected until Embryonic Day 14 (E14). Most of the E16 embryos that had been paralyzed with curare since E4 express detectable levels of both MLC1f and MLC3f in their hindlimb muscles, even though embryos incubated under these conditions do not exhibit spontaneous limb movements. Contrary to other reports, our results demonstrate that muscle contraction is not required for the accumulation of MLC3f. In light of our previous finding that innervation is essential for MLC3f accumulation in limb buds grafted onto the chorioallantoic membrane of chick hosts, these results suggest that some neural influence other than contraction, possibly a trophic factor, may play a role in the developmentally regulated expression of MLC3f in avian limb muscle.     

CRUSH SYNDROME: A HAZARD OF PROLONGED BUS JOURNEYS

SUMMARY Compartment syndrome is a devastating condition, with a high morbidity if it goes unrecognised. We describe a case that progressed to muscle ischaemia and crush syndrome in a man undergoing a prolonged bus journey while under the influence of alcohol — an unusual presentation whose outcome is dependent on early recognition.     

Plasmodium vivax: a cause of malnutrition in young children

We studied the aetiology of malnutrition in a cohort of 1511 children < 10 years old in Espiritu Santo, Vanuatu. Malnutrition was categorized using standard anthropometric criteria as: underweight [weight-for-age (WA) Z score < -2], wasting [weight-for-height (WH) Z < -2], or stunting [height-for-age (HA) Z < -2]. On multiple logistic regression analysis, the only factors significantly associated with wasting were age < 5 years [OR (95% CI) 1.8 (1.2-2.9), p = 0.01] and having suffered one or more episodes of clinical P. vivax malaria in the 6 months preceding nutritional assessment [OR 2.4 (1.3-4.4), p = 0.006]. The incidence of P. vivax infection was significantly higher during the 6 months preceding assessment in underweight vs. non-underweight children [incidence rate ratio (IRR) 2.6 (1.5-4.4), p < or = 0.0001). These groups had similar incidences of clinical P. falciparum infection during the same period [IRR 1.1 (0.57-2.1) p = 0.8] and of either species during the 6 months following assessment [IRR P. vivax 1.3 (0.9- 2.0) p = 0.2; IRR P. falciparum 1.3 (0.9-1.9) p = 0.2]. In these children, P. vivax malaria was a major predictor of acute malnutrition; P. falciparum was not. Wasting neither predisposed to nor protected against malaria of either species. Although P. vivax malaria is generally regarded as benign, it may produce considerable global mortality through malnutrition.      

Adverse reactions in blood donors with a history of seizures or epilepsy

BACKGROUND: Individuals with epilepsy or seizure disorders are restricted from donating blood because of concern that they are prone to adverse donor reactions such as syncope and convulsions. A study evaluating whether that concern is warranted is reported. STUDY DESIGN AND METHODS: During a 2-year period beginning in 1987, blood donors in Maryland with a history of seizures were actively recruited by the American Red Cross. Adverse donor reactions were classified as "slight", indicating dizziness and nausea without loss of consciousness; "moderate," denoting syncope; and "severe," indicating convulsive syncope. RESULTS: There were 329,143 satisfactory blood donations; 613 individuals reporting a history of seizures donated blood a total of 723 times. Among donors with seizures, 186 (35.7%) were taking antiepileptic medication, and 61 (8.4%) had had one or more seizures in the preceding year. Individuals with seizures had a low incidence of adverse reactions (3.34%). Although this incidence was slightly higher than that in the entire population (2.24%), the difference was not significant. In particular, the risk of syncope with or without convulsive activity was low for people with seizures (0.21%) and not significantly greater than that in other donors (0.28%). CONCLUSION: Individuals with seizures or epilepsy are not at greater risk for adverse reactions after blood donation, and major restrictions on their participation as blood donors are not warranted.     

The significance of third-generation HCV RIBA-indeterminate, RNA-negative results in voluntary blood donors screened with sequential third-generation immunoassays

BACKGROUND: One of the problems associated with the use of anti-HCV immunoblot assays is the interpretation of indeterminate results without detectable HCV RNA. The purpose of this study was to examine the significance of third-generation RIBA (RIBA-3)-indeterminate, RNA-negative results in voluntary blood donors. STUDY DESIGN AND METHODS: Since June 2000 all Australian Red Cross Blood Service testing sites have used an anti-HCV sequential immunoassay testing strategy whereby donors who are reactive on the primary screening immunoassay are tested on a secondary immunoassay and if reactive on both assays, further tested by immunoblot. From the four testing sites that use RIBA-3, the result profiles of donors who were RIBA-3-indeterminate, HCV RNA-negative were analyzed. RESULTS: From 2,661,786 donations screened for anti-HCV during the study period, 102 RIBA-3-indeterminate, RNA-negative donors were identified, most of whom were reactive to either c33p (69.6%) or c22p (27.5%). The RIBA-3-indeterminate, RNA-negative donors showed a significantly higher screening immunoassay signal strength to assay cutoff (S/CO) distribution than those with biologic false-reactive (BFR) results (1.853 vs. 1.524, p < 0.05) but a significantly lower distribution than RIBA-3-positive, RNA-negative (1.853 vs. 4.546, p < 0.05) or RNA-positive (1.853 vs. 6.467, p < 0.05) donors. The RIBA-3-indeterminate, RNA-negative donors showed a similar distribution of c33c and c22p band intensities compared with RIBA-3-positive, RNA-negative donors but significantly lower distribution of band strengths compared to the RIBA-3-positive, RNA-positive group. Compared to the indeterminate donors with previous anti-HCV-negative or BFR results, the indeterminate donors not previously screened for anti-HCV showed higher immunoassay S/CO ratio distributions, a higher proportion with c22p reactivity (16.2% vs. 36.7%), and higher frequency of risk factors (46.4% vs. 75.0%). CONCLUSIONS: Our analysis suggests that a combination of indicators can be used to help clarify RIBA-3-indeterminate, RNA-negative results. Specifically, donors with high S/CO ratios on a screening immunoassay, RIBA-3 reactivity to c22p or c33c with band intensity of 2+ or greater, without a previous history of negative or BFR donations and with an identifiable risk factor, have a high probability of representing true anti-HCV rather than nonspecific reactivity.