Tooth replantation after traumatic avulsion: a 27-year follow up

Abstract  – This report presents a case of replantation of a traumatically avulsed central incisor in a 32-year-old woman. The tooth was replanted after a 30-min extra-alveolar period. Emergency unconventional immobilization was performed, using 2–0 chromic gut, and a restorative composite made Gunning-type splint. The tooth is still in place 27 years after replantation (1976 to date) without marked resorption.     

The development and reliability of the Cantonese version of the Allen Cognitive Level Screen

The Allen Cognitive Level Screen is a quick screening test to assess the cognitive functions of people with cognitive impairments or psychiatric disabilities. The purposes of the study were to translate the Allen Cognitive Level Screen into Cantonese and to gather evidence of the reliability of the translated version. Translation was performed by three bilingual occupational therapists. A panel of another five bilingual occupational therapists verified the accuracy of translation. Thirty randomly selected Cantonese‐speaking healthcare workers performed the Cantonese version of the Allen Cognitive Level Screen. Results suggested that the test seemed to be accurately translated. Inter‐rater reliability and the test–retest coefficient of the Cantonese version of the Allen Cognitive Level Screen were 0.98 and 0.73 (test–retest interval = 28.3 days) respectively. Future research should be directed towards further exploring the psychometric properties and clinical application of the Cantonese version of Allen Cognitive Level Screen. Copyright © 2001 Whurr Publishers Ltd.     

Association of autoantibodies to glucose‐6‐phosphate isomerase with extraarticular complications in rheumatoid arthritis

Objective

In the K/BxN mouse model, autoantibodies against glucose‐6‐phosphate isomerase (GPI) cause arthritis. The relevance of this model for human disease remains a subject of controversy. We set out to determine whether GPI autoantibodies occur in patients with rheumatoid arthritis (RA) and, if so, at what stage of the RA.

Methods

Using an enzyme‐linked immunosorbent assay, serum from 131 RA patients and 28 healthy controls was tested for autoantibodies against recombinant human GPI. Patients were grouped according to disease duration and presence of rheumatoid nodules, rheumatoid vasculitis, and Felty's syndrome, which are extraarticular complications of RA.

Results

Elevated levels of autoantibodies against GPI were present in 5% of patients with uncomplicated RA and 4% of controls. In RA complicated by extraarticular manifestations, anti‐GPI antibodies were observed in 18% of patients with rheumatoid nodules, 45% of patients with rheumatoid vasculitis, and 92% of patients with Felty's syndrome.

Conclusion

In patients with RA, autoantibodies to GPI are associated with the occurrence of extraarticular complications.

     

Dysfunction of tubular phosphate reabsorption related to glomerular filtration and blood glucose control in diabetic children

Summary The renal handling of inorganic phosphate was studied by measuring the urinary excretion rate of phosphate ( ), phosphate-(Cr⁵¹) EDTA clearance ratio ( ) and maximal tubular reabsorption of phosphate per litre glomerular filtrate ( ) during fasting in 26 ambulatory Type 1 (insulin-dependent) diabetic children without clinical signs of microangiopathy (age: 7–14 years; duration of disease: 3–14 years). Similar measurements were made in 28 healthy schoolchildren (age: 8–14 years). and were significantly enhanced in the diabetic children (p<0.001) and correlated with the degree of hyperglycaemia (p<0.005). was significantly suppressed in the diabetic children (1.23 versus 1.73 mmol/1, p<0.001). This disturbance was neither related to changes in serum parathyroid hormone nor to growth hormone concentrations but was inversely correlated with the degree of hyperglycaemia (r=-0.61, p<0.001) and with tubular reabsorption of glucose in the diabetic subjects, the mean maximal ( ) and absolute tubular phosphate reabsorption rates were equal to those of the 28 healthy subjects. Both in the diabetic and healthy subjects, these parameters were positively correlated with glomerular filtration rate which was significantly elevated in the diabetic children (138 versus 109 ml/min per 1.73 m², p<0.01). The study demonstrates a dysfunction in tubular phosphate reabsorption in diabetic children which is related to glycaemic regulation.     

Hyperamylasemia, specific pancreatic enzymes, and hypoxanthine during recovery from diabetic ketoacidosis

The contribution of the exocrine pancreas to hyperamylasemia in diabetic ketoacidosis was investigated by measuring total amylase, salivary and pancreatic isoamylases, cathodic trypsin-like immunoreactivity, and pancreatic lipase in 12 consecutive patients recovering from diabetic ketoacidosis. Hyperamylasemia was present in six of the patients [50%; expected incidence: 21.1-78.9% (95% confidence limits)]--in five with simultaneously increased activities of all three specific pancreatic enzymes, and in one with only increased salivary isoamylase. The serum concentration of hypoxanthine--an indicator of the cellular energy state--was above normal in all patients at admission. We found no differences in concentrations of hypoxanthine in serum of patients with or without hyperamylasemia or in patients with or without increases in the specific pancreatic enzymes. In none of the patients was the clinical course or the time--concentration curves of the pancreatic enzymes consistent with acute pancreatitis. The pathogenic mechanism leading to hyperamylasemia in diabetic ketoacidosis remains uncertain.     

Rheumatoid arthritis: explanatory power of specific radiographic findings for patient clinical status

Radiographs of the hands and wrists of 201 patients with rheumatoid arthritis (RA) were scored for erosion, joint space narrowing, and malalignment. The explanatory power of these findings for measures of clinical status was studied with stepwise multiple linear regression analyses. Radiographic scores explained 59.2% of variation in physical joint count deformity scores, 58.5% of variation in limited motion scores, 22.5% of variation in grip strength scores, 20.5% of variation in button test scores, and 13.5% of variation for the American Rheumatism Association (ARA) Functional Class. Malalignment scores best explained variation in physical deformity, limited motion, and button test scores; joint-space-narrowing scores best explained variation in grip strength; erosion scores best explained variation in ARA Functional Class. When age, duration of disease, erythrocyte sedimentation rate, and rheumatoid factor titer were included in the regression analyses, results were similar to those without these variables. Therefore quantitative scores of specific radiographic findings are in themselves explanatory for measures of clinical status.     

CUTANEOUS VASOCONSTRICTION WITH ALERTING STIMULI IN RABBITS REFLECTS A PATTERNED REDISTRIBUTION OF CARDIAC OUTPUT

1. In conscious rabbits, when alerting stimuli elicit vasoconstriction in the ear vascular bed, there is little or no associated change in cardiac output (CO), as measured by chronically implanted Doppler ultrasonic probes. 2. Local anaesthetic injected around the base of the ear substantially diminished the degree of the vasoconstriction elicited during responses. 3. Our results emphasize that selective cutaneous vasoconstriction, an integral part of the response to alerting stimuli in conscious animals, is part of a patterned redistribution of the CO, organized by the brain.     

The effect of etidronate disodium (EHDP) on retinopathy in insulin-dependent diabetic patients

In a randomized double-blind study the effect of etidronate disodium (EHDP) on retinopathy, plasma inorganic phosphate and blood oxygen transport was assessed in 26 insulin-dependent diabetic patients.Following 6 months of EHDP administration, plasma inorganic phosphate had increased significantly (1.48 vs 1.14 mmol/l;P < 0.01). Red cell, 2,3-diphosphoglycerate concentration (16.9 vs 15.1 mol/g Hb;P < 0.01) and the haemoglobin-oxygen affinity measured by pO₂ at 50% oxygen saturation (P₅₀) had also increased significantly (27.5 vs 26.3 mmHg;P < 0.01). No changes had occurred in mean blood glucose and haemoglobin A_1c concentrations, indicating a comparable degree of glucose regulation. Following 6 months of EHDP administration an association as found between improvement in retinopathy and the increase in plasma inorganic phosphate.Department of Ophthalmology     

成熟心肌细胞的分离与培养方法

0　引言　我们介绍一种在无血清培养基中分离和培养成熟心肌细胞的方法[1,2],着重强调对优化心肌细胞培养至关重要的分离过程.1　材料　分离装置可用典型的Langandorff装置,配合无菌操作要求,对心脏进行逆行灌注.基本灌流液(溶液A),是用纯水和高纯度试剂制备,其成分有(mmol·L-1):NaCl130;HEPES23;葡萄糖21;牛磺酸20;肌酸5;MgCl25;丙酮酸钠5;KCl4.5;NaH2PO41;pH7.3.过滤(0.2μm滤纸片)溶液除去微生物和水颗粒.A溶液是分离过程中使用的其他4种溶液的原料:1750μmol·L-1Ca2+溶液(300mLA溶液+750μmol·L-1Ca2+);2游离Ca2++EGTA…