Management of tooth resorption

A correct diagnosis and an understanding of the aetiology and dynamics of the processes involved in tooth resorption is critical to effective management. Tooth resorptions can be classified as: (1) trauma induced; (2) infection induced; or (3) hyperplastic invasive. Some transient trauma induced resorptions require no treatment but must be carefully monitored to check that there are no complicating issues such as infection. In cases of trauma induced replacement resorption, a multidisciplinary approach is usually necessary to ensure an optimal long-term solution. Infection induced tooth resorptions require the removal of the invading micro-organisms by endodontic therapy including intra-canal medication which can also facilitate repair of the resorbed tooth structure. The hyperplastic invasive tooth resorptions pose considerable challenges in management due to the complexity and aggressive nature of the resorptive process. With careful case selection and complete inactivation of resorptive tissue successful management can be achieved.     

Randomised comparison of ondansetron and metoclopramide plus dexamethasone for chemotherapy induced emesis

The serotonin (5HT3) antagonist ondansetron was compared in a randomised study with metoclopramide and dexamethasone for the prevention of chemotherapy induced emesis. Thirty children aged 1-15 years with acute lymphoblastic leukaemia received 'intensification modules' according to the MRC United Kingdom acute lymphoblastic leukaemia regimen UKALL XI. This contains the moderately emetogenic drugs daunorubicin, etoposide, and cytarabine. Fifteen children received an intravenous loading dose of ondansetron followed by intravenous or oral doses 12 hourly for five days. Fifteen children received intravenous metoclopramide every six hours for three days with a loading dose of dexamethasone, repeated every eight hours for three days intravenously or orally. Efficacy was assessed by a diary card documenting the incidence of nausea, retching, or vomiting. In the 24 hour period after starting chemotherapy, ondansetron was more effective, with a complete or major response rate of 93%, compared with 33% using metoclopramide/dexamethasone.     

争光霉素A6和它在争光霉素复合物的地位

争光霉素A₅已鉴别为Bleomycin A₆,在争光霉素复合物中所占比例一般在10%左右,在某些批样中可高达15%以上。文献报告Bleomycin A₆在天然产的Bleomyein复合物中只有痕量。通过向发酵培养基中加入特定组分的末端胺可大大提高其特定组分在复合物中的含量比而其它组分的产生则不同程度地被抑制。但Bleomyein A₆例外,即使向培养基中加入其末端胺精胺(0.3mg/ml),在所产生的复合物中大大增多的组分是Bleomyein A₆,而Bleomycin A₆仍只有痕量。这表明争光霉素产生菌有和Bleomycin产生菌明显不同的特点。     

Resolution of Thrombi in Left Atrial Appendage Aneurysm

Atrial appendage aneurysm is a rare cardiac disease and may be complicated by embolic events and rhythm disturbances. We describe a case of a congenital left atrial aneurysm presenting with a cere-brovascular accident in a 57-year-old female. The diagnosis was made by transesophageal echocardiography, which revealed the presence of intraaneurysmal thrombi. The patient initially received anticoagulant therapy and the thrombi were resolved. Subsequently, she was successfully operated on and the aneurysm was removed. This is the first report of thrombi resolution in a left atrial appendage aneurysm.     

PREVALENCE OF ENDEMIC GOITRE IN SCHOOL CHILDREN: SHIRUR (DIST. PUNE,MAHARASHTRA)

A survey for estimation of goitre in school children in the Rural Health Training Centre, Shirur area was undertaken. A total of 4664 students from 17 schools were surveyed. The goitre prevalence was found to be 59.8% with visible goitre rate of 6.2% in pre- and peri-adolescent (10–19 years) age group. Thus a highly endemic goitre focus was located in Shirur, area in Pune District (Maharashtra). This area is located on the eastern tail-end slopes of Sahyadri Hills in Balaghat ranges, situated at an altitude of 533 metres. The area is generally drought prone and receives scanty rain, with poor agricultural practices. Environmental deficiency of iodine was found to be the main cause for this high prevalence of goitre.KEY WORDS: Goitre endemic, Iodine     

RORSCHACH RESPONSE PATTERNS IN ADOLESCENT SCHIZOPHRENICS

Analysis of Rorschach response patterns of 30 adolescent schizophrenics and an equal number of age and sex matched normal adolescents was undertaken. Two of the five Thiesen''s patterns associated with schizophrenia, namely pattern C and D, occurred significantly more frequently in Rorschach responses of adolescent schizophrenics as compared to normal controls.KEY WORDS: Rorschach test, Schizophrenia     

Pigmented eccrine poromas: expression of melanocyte-stimulating cytokines by tumour cells does not always result in melanocyte colonization

Background Although eccrine poroma (EP) occurs preferentially in palmoplantar areas, pigmented variants of EP have not been documented on the palms and soles. Objectives We seek to confirm the notion regarding lack of pigmented EP on palmoplantar areas and determine whether the absence of pigmentation in palmoplantar EPs is due to lack of expression of melanocyte‐stimulating cytokines by tumour cells. Methods We searched the PubMed and Web of Science databases (1966–2006) for reports of pigmented EPs. In addition, a total of 17 EPs were collected from our pathology department. The presence of melanin was examined with haematoxylin‐eosin sections, and melanocyte colonization was shown by immunohistochemical stains for tyrosinase. In addition, immunohistochemical staining with antibodies to melanocyte‐stimulating cytokines, including endothelin‐1, stem cell factor, and nerve growth factor, was done on these tumours. Results A review of the literature revealed 15 pigmented EP reports, none of which were located in palmoplantar areas. Among 17 EPs collected from our pathology department, 7 occurred in palmoplantar areas and 10 in non‐palmoplantar areas. Three of the palmoplantar EPs and three of the non‐palmoplantar EPs showed positive staining with melanocyte‐stimulating cytokines. However, none of the palmoplantar EPs contained melanocytes or melanin pigment, wheras the three non‐palmoplantar EPs that stained positively with melanocyte‐stimulating cytokines were colonized with melanocytes and showed pigmentation clinically. Conclusions The expression of melanocyte‐stimulating factors by tumour cells is associated with melanocyte colonization in non‐palmoplantar EPs but not palmoplantar EPs. Therefore, the presence of melanocyte‐stimulating cytokines per se is not sufficient by itself to induce melanocyte colonization. Certain characteristics of palmoplantar skin, such as the dermal components of these anatomical sites, may play a role in inhibiting melanocyte colonization of EPs.     

Service users' experiences of obtaining and giving information about disorders of sex development

Objective  To quantify participants' experiences of obtaining and giving information about disorders of sex development (DSD).
Design  Cross-sectional survey study that asked people about their current and past experiences relating to DSD disclosure.
Setting  A large tertiary referral centre for DSD management in the UK.
Population  One hundred of 126 people with a confirmed diagnosis of DSD who were invited to participate in the study formed the usable sample.
Methods  All people who attended clinic for follow-up during the study period and members of a patient support group whose annual meeting fell within the study period were asked to complete the Middlesex Communication Survey.
Main outcome measures  The Middlesex Communication Survey.
Results  Younger participants were more likely to report having been appropriately informed about their diagnosis than older people. Nearly half of the former had been fully informed about their diagnosis by age 15 years, compared with 0% of the older age group. In terms of information sharing, mothers were most likely to be the person with whom the participant had shared (almost/all) DSD information (74%), followed by current partners (71%). Information relating to genital surgery, presence of testes and clitoral anomalies were the least likely aspects to have been unambiguously shared with even the most informed person.
Conclusions  Our results suggest that difficulties in obtaining DSD information from care providers were common, and that communication has improved for younger participants. The study also confirmed that many people with DSD continue to struggle with confiding, even in those closest to them, about aspects of their diagnosis. Care protocol needs to centralise psychological adaptation, which should also be a primary focus for future research.