A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months

BACKGROUND: The authors evaluated the 24-month performance of a packable resin-based composite/dentin bonding system and a high-viscosity glass ionomer cement (GIC) in restorations placed in primary molars with the atraumatic restorative treatment (ART) approach. METHODS: Three dentists placed 419 restorations in 219 children aged 6 through 10 years who had bilateral matched pairs of carious posterior Class I and II primary teeth. They used a split-mouth design to place the two materials, which were assigned randomly to contralateral sides. The authors evaluated the restorations according to U.S. Public Health Service Ryge criteria. RESULTS: After 24 months, 96.7 percent of the Class I GIC restorations and 91 percent of the resin-based composite restorations survived, while the success rates for the Class II restorations were 76.1 percent and 82 percent for the GIC and resin-based composite restorations, respectively. The survival rate of the Class II resin-based composite restorations was 5.9 percent higher than that of the GIC restorations at the 24-month evaluation, but this difference was not statistically significant. However, the study results showed a statistically significant difference in survival rates between Class I and II restorations for both materials. CONCLUSION AND CLINICAL IMPLICATIONS: The two-year clinical performance of both materials was satisfactory for the restoration of Class I and II primary molars using the ART approach.     

Comparison of scanning electron microscopy findings regarding biofilm colonization with microbiological results in nasolacrimal stents for external, endoscopic and transcanalicular dacryocystorhinostomy

AIM:To compare bacterial biofilm colonization in lacrimal stents following external dacryocystorhinostomy (EX-DCR), endoscopic dacryocystorhinostomy (EN-DCR), and transcanalicular dacryocystorhinostomy (TC-DCR) with multidiode laser.METHODS: This prospective study included 30 consecutive patients with nasolacrimal duct obstruction who underwent EXT-, EN-, or TC-DCR. Thirty removed lacrimal stent fragments and conjunctival samples were cultured. The lacrimal stent biofilms were examined by scanning electron microscopy (SEM).RESULTS:Eleven (36.7%) of the 30 lacrimal stent cultures were positive for aerobic bacteria (most commonly Staphylococcus epidermidis and Pseudomonas aeruginosa). However anaerobic bacteria and fungi were not identified in the lacrimal stent cultures. Twenty-seven (90%) patients had biofilm-positive lacrimal stents. The conjunctival culture positivity after the DCR, biofilm positivity on stents, the grade of biofilm colonization, and the presence of mucus and coccoid and rod-shaped organisms did not significantly differ between any of the groups (P＞0.05). However, a significant difference was found when the SEM results were compared to the results of the lacrimal stent and conjunctival cultures (P＜0.001).CONCLUSION: Type of dacryocystorhinostomy (DCR) surgery did not affect the biofilm colonization of the lacrimal stents. SEM also appears to be more precise than microbiological culture for evaluating the presence of biofilms on lacrimal stents.     

Single coronary artery with anomalous origin of the right coronary artery from the left anterior descending artery with a unique proximal course

A 62-year-old man with hypertension and hypercholesterolemia was referred to our unit for evaluation of chest pain. A very rare variant of single coronary artery, in which the anomalous right coronary artery originated as a separate branch from the left anterior descending artery, was incidentally found on his coronary angiography. The anomalous right coronary artery in our case appears to be unique in that it courses intraseptally rather than rightwards proximally and has obstructive atherosclerotic lesions resulting in inferior ischemia. Moreover, the acute angle made by the anomalous right coronary artery to turn toward the atrioventricular groove may have reduced the flow velocity and contributed to the development of inferior ischemia.     

Functional and structural basis of the nuclear localization signal in the ZIC3 zinc finger domain

Disruptions in ZIC3 cause heterotaxy, a congenital anomaly of the left-right axis. ZIC3 encodes a nuclear protein with a zinc finger (ZF) domain that contains five tandem C2H2 ZF motifs. Missense mutations in the first ZF motif (ZF1) result in defective nuclear localization, which may underlie the pathogenesis of heterotaxy. Here we revealed the structural and functional basis of the nuclear localization signal (NLS) of ZIC3 and investigated its relationship to the defect caused by ZF1 mutation. The ZIC3 NLS was located in the ZF2 and ZF3 regions, rather than ZF1. Several basic residues interspersed throughout these regions were responsible for the nuclear localization, but R320, K337 and R350 were particularly important. NMR structure analysis revealed that ZF1-4 had a similar structure to GLI ZF, and the basic side chains of the NLS clustered together in two regions on the protein surface, similar to classical bipartite NLSs. Among the residues for the ZF1 mutations, C253 and H286 were positioned for the metal chelation, whereas W255 was positioned in the hydrophobic core formed by ZF1 and ZF2. Tryptophan 255 was a highly conserved inter-finger connector and formed part of a structural motif (tandem CXW-C-H-H) that is shared with GLI, Glis and some fungal ZF proteins. Furthermore, we found that knockdown of Karyopherin alpha1/alpha6 impaired ZIC3 nuclear localization, and physical interactions between the NLS and the nuclear import adapter proteins were disturbed by mutations in the NLS but not by W255G. These results indicate that ZIC3 is imported into the cell nucleus by the Karyopherin (Importin) system and that the impaired nuclear localization by the ZF1 mutation is not due to a direct influence on the NLS.     

Angiographic restenosis after myocardial bridge stenting

Data on restenosis after stent implantation in myocardial bridges (MB) are very limited. Six-month angiographic results for 12 symptomatic patients who underwent stent implantation for myocardial bridges were compared retrospectively with those of 39 patients who underwent direct stent implantation for de novo atherosclerotic lesions in the left anterior descending artery. Diameter stenosis decreased from 69 +/- 8% to 4 +/- 5% in the MB group and from 79 +/- 8% to 7 +/- 6% in the control group after stent deployment. Systolic narrowing was abolished in all patients with MB. In follow-up, quantitative angiography revealed late loss of 1.8 +/- 1.3 mm in the MB group and 0.9 +/- 0.9 mm in the control group (P = 0.025). The in-stent restenosis rate was also higher in the MB group compared to the control group (67% versus 28%; P = 0.037). Despite favorable immediate results, stent implantation in MBs may not be promising because of the higher in-stent restenosis rate compared to stenting in de novo atherosclerotic lesions.     

Intra-Left Atrial Mechanical Delay Detected by Tissue Doppler Echocardiography Can Be a Useful Marker for Paroxysmal Atrial Fibrillation

Objectives: There are some clinical and echocardiographic parameters to predict paroxysmal atrial fibrillation (PAF), but more sensitive predictors are needed. Tissue Doppler imaging may be a sensitive method for this purpose. Methods: Thirty-four patients with PAF and 31 control subjects were studied. Time intervals from the beginning of P-wave to beginning of A-wave from lateral and septal mitral and right ventricular tricuspid annuli in tissue Doppler imaging were recorded. The differences between these intervals gave the mechanical delays between/within the corresponding atria. Results: There were no differences between groups with regard to age. PAF patients were found to have increased left atrial dimension and intra-left atrial mechanical delay. Twenty-five milliseconds was calculated as cutoff value to predict PAF. P-wave dispersion was found to be increased in PAF. Conclusions: This study shows an increase in intra-left atrial mechanical delay in PAF patients. This method can be used as an early marker to detect PAF.     

Apoptosis in the traumatic and degenerative tears of human meniscus

The apoptotic bodies were observed aging in osteoarthritic cartilage and meniscus but there is still a lack of knowledge in the literature about the relationship between meniscal injury and apoptosis. The aim of this study is to investigate the apoptotic changes on meniscal tears caused by degeneration and trauma. Thirty-eight specimens of human meniscal tissues harvested from cadavers and patients were selected from groups below the age of 40. There were 14 normal meniscal tissues from cadavers in the control group. There were 24 meniscal tissues harvested from patients who had had arthroscopic operations for meniscal tear due to degeneration or trauma. The torn meniscal samples were divided into two groups according to their etiologies, either degenerative or traumatic. Apoptotic cells were investigated in each of the three groups in the histopathological examination. There was statistically significant difference among the groups according to apoptotic index (p < 0.01). The mean indexes of apoptosis in both groups of torn meniscus (group 2 = 0.497 and group 3 = 0.725) were significantly higher than that in the normal tissue (group 1 = 0.237) (p < 0.01) but the difference between groups 2 and 3 was not significant (p > 0.001). This study indicates that an increase in the amount of apoptosis appeared to have a close relationship with meniscal tear caused by either trauma or degenerative changes.