Protective effect of different lining materials placed under composite resin restorations in monkeys

abstract — The protective qualities of the cavity lining materials Tubulitec®, Dycal®, Dycal+Tubulitec and De Trey® phosphate cement were tested beneath the composite resin Addent Concise® in 153 monkey teeth. Insufficient pulpal protection was obtained from restorations lined with the phosphate cement, while the three other lining procedures gave good protection.     

High Occurrence of Mitral Valve Prolapse in Cardiac Catheterization Patients with Pure Isolated Mitral Regurgitation

ABSTRACT. Danielsen R, Nordrehaug JE, Vik-Mo H (Department of Clinical Physiology, Haukeland Hospital, University of Bergen, Bergen, Norway). High occurrence of mitral valve prolapse in cardiac catheterization patients with pure isolated mitral regurgitation. Acta Med Scand 1987; 221:33–8. The aetiological spectrum of angiographically verified pure isolated mitral regurgitation (MR) was studied in 48 consecutive adult patients (35 males). Severe MR was found in 35 patients (73%) and moderate MR in 13 patients (27%). Mitral valve prolapse (MVP) syndrome was found in 21 patients (44%). These were younger than the rest of the study population (55±13 vs. 62±6 years, p<0.05) and 15 (71%) of them were men. Endocarditis and chordal rupture occurred in 19% and 43% of the MVP patients. Sixteen patients (33%) had MR secondary to myocardial infarction while only three patients (6%) had MR of rheumatic aetiology. Bacterial endocarditis, hypertensive heart disease, hypertrophic obstructive car-diomyopathy and mitral annulus calcification were less frequently found. Mitral valve replacement was done in 20 (57%) of the patients with severe MR and MVP was the underlying disease in 15 (75%) of these patients. In conclusion, MVP is a frequent cause of pure isolated MR and of mitral valve replacement. In contrast to the preponderance of young females amongst MVP patients in population surveys, most of the MVP patients with MR in this study are middle-aged and elderly men.     

NEONATAL HYPERTHYROIDISM

Neonatal Graves disease, with frank cardiac failure and pronounced bilateral breast enlargement, is described in a premature infant female. Thyrotoxicosis, culminating rapidly in thyroid storm, was successfully treated by administration of Lugol's solution, digitalis and phenobarbital. The case is discussed in reference to the legitimacy of long-acting thyroid stimulator (LATS) as the originator of neontal thyrotoxicosis. Although LATS could not be detected, the occurrence of gastric parietal cell antibodies in both mother and child yielded presumptive evidence for thyrotoxicosis as an autoimmune disease.     

Experimental periodontal breakdown in the dog

abstract – This paper describes a method for inducing rapidly progressing and reproducible periodontal lesions around selected teeth in dogs. The experiments were performed on 10 beagles which were fed a diet favoring gross formation of plaque. Approximately 1 mm of the marginal alveolar bone around ₄P and P₄ was removed and a notch prepared in the root. A ligature of cotton floss was placed around ₄P and P₄ at the cemento-enamel junction. Radiographs and sections prepared 230 d later revealed that a progressive breakdown of the periodontal tissues had occurred. The average bone loss was 2.4 mm and the distance between the apical cells of the pocket epithelium and the notch was 854μm.     

Shear Bond Strengths of One-Bottle Adhesives to Moist Enamel

Abstract: Purpose: This study evaluated bond strengths of six one-bottle bonding agents and a control (primer plus unfilled resin) to moist enamel.
Materials and Methods: One-hundred and five bovine teeth were randomly assigned to seven groups of 15. Enamel was etched for 15 seconds with 35% phosphoric acid. Etched enamel was rinsed, and excess water was blotted with tissue paper. Following application of the adhesive, composite resin was bonded using a gelatin capsule technique. Shear bond strengths to enamel were determined using a universal testing machine (Instron Corp., Canton, Massachusetts).
Results: Mean bond strengths ranged from 21.9 MPa for OptiBond Solo (Kerr Corp., Orange, California) to 29.6 MPa for Prime & Bond 2.1 (Dentsply/Caulk, Milford, Delaware). Prime & Bond 2.1 had a significantly higher mean bond strength than the other adhesives.
CLINICAL SIGNIFICANCE: The results of this study suggest that all of the one-bottle systems tested should provide clinically acceptable bonding to moist enamel.     

Does activation of the baroreceptors reinforce differential Pavlovian conditioning of heart rate responses?

High- and low-pitched tones (CS+ and CS?) signalled baroreceptor stimulation or inhibition (US+ and US-) on 6-s conditioning trials (n= 128). Baroreceptor stimulation was induced by the phase-related external suction (PRES) method of Rau et al. (1992) in which a brief pulse of negative external pressure is applied to the neck at systole and one of positive pressure at diastole within each cardiac cycle (the reverse sequence is used for baroreceptor inhibition). Changes in heart period (R-R intervals) confirmed that PRES manipulated the baroreceptors in the presence of CS+ and CS? without habituation over conditioning trials. However, conditioned heart period responses were not observed on test trials (n= 32) in which CS+ and CS? were presented with the baroreceptor manipulation removed. Subjects were unable to state which CS had signalled baroreceptor stimulation and inhibition when given PRES-alone trials after the conditioning phase (differential attention thus controlled). These results (a) confirm that the differential effect of the two PRES stimuli was specific to the baroreceptors and (b) support earlier studies that have found that differential conditioning is impaired when CS?US relations are not processed in attention. We discuss implications regarding when baroreceptor firing might be discriminable and reinforcing.     

Coronary heart disease and upper airway obstruction

SUMMARY  Coronary heart disease (CHD) is a leading cause of death among middle-aged men. In the same age group the spectrum of upper airway obstruction from habitual snoring to obstructive sleep apnoea syndrome (OSAS) is frequent. In several studies snoring was found to be an important risk factor for ischaemic heart disease. The prevalence of OSAS in patients with CHD, profile of risk factors and ventricular arrhythmias was determined in a prospective manner in 78 patients with stenosis of one or more coronary arteries at coronary arterography. OSAS was found in 27 patients (34.6%). Mean respiratory disturbance index (RDI) was 23.9. RDI increased with higher age. No significant differences in both groups could be found in ventricular arrhythmias, left ventricular ejection fraction and risk factors, except hyperuricaemia and adiposity. OSAS is frequent in patients with CHD and may be an additional risk factor besides the known coronary risk factors. Patients with the combination of CHD and OSAS have to be regarded as a group at particular risk because of several interactions between OSAS and coronary haemodynamics. Furthermore the microstructure of sleep in patients with nocturnal myocardial ischaemia is disturbed.     

The influence of sympathetic nerve activity on axial position of the rabbit incisor tooth

Changes in position of the upper front tooth in response to sectioning and subsequent electrical stimulation of the cervical sympathetic nerves were studied in 25 anesthetized rabbits. The position was continuously recorded by an ultrasonic transit time technique. Sectioning of the nerves was found to induce an average tooth extrusion of about 7 μm. Sympathetic nerve stimulation for periods of 20–30 s caused intrusion of the tooth, with about 70% of maximum occurring at 2 Hz stimulations. The intrusive response was reduced by phentolamine. Neither atropine nor propranolol affected the stimulation response, but the latter drug led to marked extrusion of the tooth. In conclusion, the position of the rabbit's front tooth was found to be highly sensitive to alterations in sympathetic nerve activity to the vasculature of the tooth-supporting tissues.     

Stenting of Native Right Ventricular Outflow Tract Obstructions in Symptomatic Infants

Objective

To assess feasibility, safety and effectiveness of right ventricular outflow tract (RVOT) stenting in symptomatic young infants.

Methods

Multicentre evaluation of 35 patients intended to undergo RVOT stenting in 11 pediatric cardiac centres from 2009 to August 2011.

Results

Median age and weight at the time of first stent implantation were 8 weeks and 3.3 kg, with 40% of patients <3 kg. A total of 19 patients had suffered from hypoxemic spells, 8 patients were ventilated, 6 on inotropic support and 5 on prostaglandin infusion. Severe concomitant malformations were present in 11 patients, and acute infections in 2. Stenting of the RVOT was successfully performed in 33 patients, improving oxygen saturation from a median of 77 to 90% 2 days after intervention. Besides the 2 patients in whom RVOT stenting was not successful for technical reasons, there were no procedural complications. In 17 of 33 patients, 1–3 reinterventions were performed during follow‐up, less than half of those were reinterventions in the RVOT. A total of 27 patients have undergone successful surgical repair 4–162 (median 19.5) weeks after initial RVOT stent implantation, 2 patients are still waiting. There were no perioperative deaths.

Conclusions

Stenting of the RVOT provides a safe and effective management strategy for initial palliation in symptomatic young infants, including those patients not suitable or at higher risk for surgical therapy. (J Interven Cardiol 2015;28:279–287)

     

Social functioning and communication in children with cerebral palsy: association with disease characteristics and personal and environmental factors

Aim The objective of this longitudinal study was to describe the course of social functioning and communication in children with cerebral palsy (CP) over a 3‐year period, its difference with the normative course, and its relationship with disease characteristics and personal and environmental factors. Method Participants in this study were 110 children with CP (70 males, 40 females) with a mean age of 11 years and 3 months (SD 1y 8mo). Social functioning and communication were measured with the Vineland Adaptive Behavior Scales. Comparisons were made with normative data; data were analysed with generalized estimating equations. According to the Gross Motor Function Classification System (GMFCS), 50 of the 110 children were categorized as GMFCS level I, 16 as level II, 13 as level III, 13 as level IV, and 18 as level V. Results The course of social functioning over a 3‐year period showed an increase in restrictions in children with CP (p<0.001). Restrictions in communication increased more in children with the most severe forms of CP (p<0.001). In addition to disease characteristics (GMFCS category, presence of epilepsy, and speech problems), personal factors (externalizing behaviour problems) and environmental factors (having no siblings, low parental level of education, and parental stress) were associated with greater restrictions in social functioning and communication. Interpretation The results indicate that it is important to focus not only on the medical treatment of children with CP, but also on their behavioural problems and social circumstances, and to support the parents so that social functioning and communication in these children may be improved.