Efficacy of an amine fluoride-triclosan mouthrinse as compared to the individual active ingredients

BACKGROUND: The purpose of the clinical study was to examine the antibacterial and plaque-reducing properties of mouthrinses containing triclosan (TRI), amine fluoride (AmF), and the combination of both (AFT) on 4-day plaque regrowth. A placebo solution (PLA) and a 0.2% chlorhexidine solution (CHX) served as negative and positive controls, respectively. MATERIALS AND METHODS: After a professional tooth cleaning (day 0), 15 volunteers refrained from all mechanical oral hygiene measures for the next 96 h and rinsed instead twice daily for 1 min with 10 ml of one of the five randomly assigned solutions. Plaque index (PlI), which was assessed after 24 and 96 h (PlI1, PlI2), and plaque area of the front teeth (PA), which was planimetrically recorded from disclosed teeth after 96 h, served as clinical parameters. After 24 and 96 h a plaque sample was taken and analyzed microbiologically to evaluate biofilm vitality (VF1, VF2). The subsequent test cycles were conducted after a washout period of 10 days each. RESULTS: No severe adverse events or allergy were seen during the study. CHX influenced all parameters at all time points in comparison to PLA. AFT and AmF showed very similar values (in all parameters), but AmF did not reach the level of significance regarding VF1, nor did AFT with VF2 and PlI1. The TRI solution only reduced PlI2 and PA significantly, but had no influence on biofilm vitality when compared to PLA. CONCLUSION: A synergism between AmF and TRI was not observed. The results suggest that the plaque-reducing and antibacterial effects of the AFT solution are mainly based on the effects of the amine fluoride moiety.     

Input dysfunction and beyond--an evaluation of CPT components

The aim of our project is to analyze the functional meaning of neurocognitive components of the Continuous Performance Tests (CPT), which may be responsible for the well-documented performance deficit. Since the CPT can be considered as a vulnerability marker for schizophrenia, this question is of special interest. We set up a test battery testing five different cognitive processing modes: perceptual organization, selective attention, short-term memory (storing component), working memory (rehearsal component), and vigilance/sustained attention. In order to avoid the pitfall of interpreting results confounded by psychometric differences within tasks, we created psychometrically parallel versions within each experimental block (following the proposals of Chapman and Chapman [J. Nerv. Ment. Dis. 171 (1983) 658]). At the main experimental session, we tested newly admitted patients with a DSM diagnosis of schizophrenia during remission (N=30), patients with major depressive disorder (MD) (N=18), and healthy controls (N=20). Results showed that differences specific for schizophrenia are seen at the experimental block, which tests perceptual organization. However, all levels of perceptual organization performance were concerned, i.e., from processing organized to non-organized patterns. The regression analysis showed that 3-7 CPT version performances could be explained by problems with short-term memory, sustained attention, and perceptual organization. In light of these findings, we discussed whether etiology of schizophrenia could be conceptualized as a circumscribed neurocognitive deficit or a multifunctional, multilocal deficit.     

Guidance of percutaneous pulmonary biopsies with real-time CT fluoroscopy

OBJECTIVE: Clinical evaluation of computed tomography (CT) fluoroscopy and comparison with conventional CT guidance for monitoring of percutaneous pulmonary biopsy procedures. METHODS: Twenty CT-guided pulmonary biopsy procedures were conducted. The interventions have prospectively been performed either with CT fluoroscopy or with conventional CT guidance. About 120 kV and 50 mA with a frame-rate of eight images per second were used for CT fluoroscopy. Number of pleural needle passages, procedure times, radiation doses and histologic results were analyzed separately for both methods. RESULTS: Compared with conventional CT guidance, CT fluoroscopy was associated with less pleural needle passages (1.8+/-0.6 vs. 1.1+/-0.3; P=0.003, t-test) and procedure times were shorter than for conventional CT guidance (12.7+/-2.2 min vs. 26.7+/-16.4 min; P=0.02). Analysis of estimated patient related radiation exposure and histologic outcome showed no significant difference between conventional and fluoroscopic CT-guided procedures (P>0.05). CONCLUSION: CT fluoroscopy facilitates guidance of percutaneous pulmonary biopsy procedures. Compared with conventional CT assistance, procedure times are decreased and less pleural needle passages are required. While patient-related radiation exposure is similar, operator-related radiation exposure remains a disadvantage associated with CT fluoroscopy.     

3-D conformal radiotherapy of localized prostate cancer: a subgroup analysis of rectoscopic findings prior to radiotherapy and acute/late rectal side effects.

BACKGROUND AND PURPOSE: To identify endoscopic pathological findings prior to radiotherapy and a possible correlation with acute or chronic rectal side effects after three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. PATIENTS AND METHODS: Between 03/99 and 07/02, a total of 298 patients, who consented in a voluntary rectoscopy prior to radiotherapy were included into the analysis. Patients were treated with a total dose of either 70 or 74 Gy. Pathological rectoscopic findings like hemorrhoids, polyps or diverticula were documented. Acute and late rectal side effects were scored using the EORTC/RTOG score. RESULTS: The most frequent pathological endosopic findings were hemorrhoids (35%), polyps (24%) and diverticula (13%). Rectal toxicity was mostly low to moderate. Grade 0/1 cumulative acute and late rectal side effects were 82 and 84%, grade 2 were 18 and 17%, respectively. We could not identify any correlation between preexisting pathological findings and rectal side effects by statistical analysis. CONCLUSIONS: There is no evidence that prostate cancer patients presenting with endoscopic verified pathological findings in the rectal mucosa at diagnosis are at an increased risk to develop rectal side effects when treated with 3D-CRT of the prostatic region.     

Soluble aminopeptidase N/CD13 in malignant and nonmalignant effusions and intratumoral fluid.

PURPOSE: On the basis of the finding of marked overexpression in angiogenic microvessels, aminopeptidase N/CD13 has recently been suggested to play a prominent role in tumor angiogenesis. A soluble form of CD13 (sCD13) is present in human plasma, but its role in cancer has not been addressed. We hypothesized that sCD13 would be shed by tumor cells and/or endothelial cells lining tumor vessels, giving high levels of sCD13 in intratumoral fluid (TF) deposits and in malignant effusions. If so, sCD13 could be a convenient potential marker for tumor load and/or activated tumor endothelium. EXPERIMENTAL DESIGN: We have measured the specific sCD13 activity in effusions from 90 cancer patients and 12 patients with a nonmalignant condition, and studied its relationship with other major (anti-)angiogenic factors. In a separate group of patients (n = 41), the relationship of sCD13 activity in plasma with tumor load was studied. RESULTS: The sCD13 activity was highest in plasma from cancer patients 71.9 (fmol/ml/s hydrolyzed substrate) versus 42.4 for healthy subjects. In TF, malignant effusions, and nonmalignant effusions, the activities were 52.8, 33.5, and 18.6, respectively. We further studied the relationship of sCD13 with tumor load as well as with vascular endothelial growth factor (VEGF), endostatin, matrix metalloproteinase (MMP)-2, MMP-9, urokinase-type plasminogen activator, and plasmin. A significant correlation of sCD13 activity in plasma was found with tumor load (r = 0.68; P = 0.01), suggesting that plasma sCD13 is, at least, partly originating from tumor(-endothelium). The concentrations of VEGF and endostatin and the activities of urokinase-type plasminogen activator and MMP-9, but not MMP-2, were significantly higher in TF compared with all other effusions. In TF, a correlation between sCD13 and VEGF was found (r = 0.67; P = 0.03). No correlation of sCD13 with the other protease activities was found. CONCLUSION: The sCD13 activity is elevated in plasma and effusions of cancer patients. A strong correlation of plasma sCD13 with tumor load was found. On the basis of these results, the potential of sCD13 activity as a tumor and/or angiogenesis marker warrants further investigation.     

Intra-hospital lethality among infants with pyogenic meningitis

Predictor variables of intra-hospital lethality among infants with pyogenic meningitis due to Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae were identified using data from a follow-up study of infants with bacterial meningitis. The infants who were admitted to Couto Maia Hospital from March 1, 1997 to December 31, 1997 presenting with symptoms of bacterial meningitis were identified and included in a database. An analysis of the clinical and laboratory information was performed using EPI info 6.01b and SPSS 6.1 statistical programs. The total mortality rate was 17.1%, and the majority of deaths occurred within 48 hours of hospitalization. Factors associated most frequently with poor outcome included absence of respiratory infection, high cerebrospinal fluid protein, and compromised cranial nerves. Early identification of major risk groups is important to adopt measures to improve prognosis.     

Bactericidal effect of different laser systems in the deep layers of dentin

BACKGROUND AND OBJECTIVES: In recent years, various laser systems have gained importance in the field of laser-assisted endodontics, namely the Nd:YAG, the diode, the Er:YAG, and the Er,Cr:YSGG laser. Individual studies have been carried out so far, focusing on the respective wavelength, its specific bactericidal capabilities, and potential usefulness is root-canal disinfection. The present in vitro investigation however, was performed to compare the microbicidal effect of these laser systems under standardized conditions and to draw a conclusion upon their relative effectiveness in the deep layers of dentin. STUDY DESIGN/MATERIALS AND METHODS: In total, 360 slices of root dentin with a thickness of 1 mm were obtained by longitudinal cuts of freshly extracted human premolars. The samples were steam sterilized and subsequently inoculated with a suspension of either Escherichia coli or Enterococcus faecalis. After the incubation, the samples were randomly assigned to the four different laser systems tested. Each laser group consisted of two different operational settings and a control. The dentinal samples underwent "indirect" laser irradiation through the dentin from the bacteria-free side and were then subjected to a classical quantitative microbiologic evaluation. To assess the temperature increase during the irradiation procedure, additional measurements were carried out using a thermocouple. RESULTS: Microbiology indicated that all laser systems were capable of significant reductions in both test strains. At an effective output power of 1 W, E. coli was reduced by at least three log steps in most of the samples by the tested wavelengths, with the best results for the Er:YAG laser showing complete eradication of E. coli in 75% of the samples. E. faecalis, a stubborn invader of the root canal, showed minor changes in bacterial count at 1 W. Using the higher setting of 1.5 W, significant reductions of E. coli were again observed with all laser systems, where only the diode and the Er:YAG laser were capable of complete eradication of E. faecalis to a significant extent. There was no significant relation between the temperature increase and the bactericidal effect. CONCLUSIONS: The present study demonstrates that all the wavelengths investigated are suitable for the disinfection of even the deeper layers of dentin and may prove to constitute valuable tools in state-of-the-art endodontics.