ANTIMICROBIAL ACTIVITY OF SODIUM HYPOCHLORITE ASSOCIATED WITH INTRACANAL MEDICATION FOR Candida albicans AND Enterococcus faecalis INOCULATED IN ROOT CANALS

Objective:

The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl) associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals.

Material and Methods:

Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12) according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX) gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a) initial sample (IS): 21 days after contamination (control), b) S1: after instrumentation, c) S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level.

Results and Conclusions:

Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.     

Aliasing artifacts with the BLADE technique: causes and effective suppression

Purpose:

To elucidate the causes of aliasing artifacts with the BLADE technique and clarify the effective suppression methods.

Materials and Methods:

We separately observed the aliasing artifacts of BLADE from features inside and then outside the defined field‐of‐view (FOV) using phantom studies. The effectiveness of suppressing them with phase oversampling (POS) and presaturation pulses (SAT) was evaluated. Finally, our observations were confirmed for a healthy volunteer.

Results:

Characteristic aliasing artifacts were observed from both inside and outside the FOV. Those from inside the FOV were sufficiently suppressed by using a POS of 25%, considering the acquisition time prolongation. Those from outside the FOV were nearly suppressed using SAT outside the FOV without selecting needless receiver coils. Aliasing artifacts on the coronal images of the head and neck with a healthy volunteer were completely suppressed by a combination of using a POS of 25% and using SAT on all four sides outside the FOV.

Conclusion:

The characteristic aliasing artifacts of BLADE are caused from both inside and outside the defined FOV. They can be effectively suppressed by a combination of using a POS of 25% and using SAT on all four sides outside the FOV. J. Magn. Reson. Imaging 2011;33:432–440. © 2011 Wiley‐Liss, Inc.     

Adenocarcinoma of the minor duodenal papilla: report of a case

We report a case of adenocarcinoma of the minor duodenal papilla, a rare type of duodenal neoplasm. A 76-year-old man with a history of surgery for rectal cancer and gastric cancer was referred to us after a follow-up upper gastrointestinal endoscopy revealed an abnormal elevation in the minor duodenal papilla. The pathological diagnosis of a biopsy specimen was adenocarcinoma. Preoperative examination of other organs revealed a tumor in the ascending colon, which was also identified as adenocarcinoma. We performed synchronous pancreatoduodenectomy and ileocecal resection with lymph node dissection. Histopathological examination of the resected specimen revealed that the papilla tumor arose from the duodenal mucosa and infiltrated the submucosa of the duodenal wall, but not the pancreatic parenchyma. Based on these findings, we diagnosed primary adenocarcinoma of the minor duodenal papilla. To our knowledge, this is only the sixth such case reported in the English-language literature, and we review all six cases after this case report.     

Successful treatment of acute promyelocytic leukemia in a patient on hemodialysis

Acute promyelocytic leukemia (APL) has the best prognosis among acute leukemias, but there is little data about APL in patients on hemodialysis. A 64-year-old hemodialysis patient was successfully treated for APL by induction therapy with all-trans retinoic acid (ATRA), three courses of consolidation therapy with Ara-C, mitomycin?C (MIT), daunorubicin (DNR), and idarubicin (IDR), and maintenance therapy with ATRA. Complete remission has been maintained for 42?months in this patient. With dose modification, ATRA and chemotherapy may be safely given to patients on hemodialysis.     

Inguinal hernia repair with the mesh plug method is safe after radical retropubic prostatectomy

Purpose

We evaluated the safety and efficiency of using the mesh plug method (MP) to repair inguinal hernias in patients with a history of radical retropubic prostatectomy (RRP). We also investigated how RRP influences the development of inguinal hernias and impacts their repair.

Methods

Among 488 adult male patients who underwent inguinal hernia repair during a recent 5-year period, 37 had a history of RRP. We compared the characteristics and surgical outcomes of the patients who had undergone RRP (post-RRP group) with those who had not (non-RRP group).

Results

All post-RRP hernias were treated by MP. The 37 post-RRP patients had a collective 41 hernias, 40 of which were of the indirect type. The side affected by the hernia did not differ significantly between the groups. We compared the short-term surgical outcomes of the indirect post-RRP hernias vs. the indirect non-RPP hernias without recurrence and incarceration. The operation times, postoperative hospital stay, and mobility rates did not differ significantly between the two groups. The blood loss was almost equal in both groups.

Conclusion

Inguinal hernia repair after RRP may be difficult because of inflammatory changes in the preperitoneal cavity, but the surgical outcomes of MP were equivalent in patients with or without a history of RPP in this study. MP is a safe and effective method for post-RPP hernia repair.     

Optimal Initial Dose of Orally Administered Once-daily Extended-release Tacrolimus Following Intravenous Tacrolimus Therapy After Liver Transplantation

Introduction

Once-daily extended-release tacrolimus (Tac-OD) is expected to reduce non-adherence in recipients after liver transplantation (LT). The aim of this study was to determine the optimal initial dose of orally administered Tac-OD after intravenous tacrolimus (Tac-IV) therapy after LT.

Patients and Methods

This prospective study included 10 adult recipients who had undergone LT at our institute. The recipients were prescribed tacrolimus by continuous intravenous administration with a steroid as initial immunosuppression therapy. Tacrolimus was converted from intravenous administration to once-daily oral intake when gastrointestinal function returned. We evaluated tacrolimus concentrations in blood 9 times a day and area under the blood concentration−time curve (AUC) during conversion. The optimal initial dose of Tac-OD was determined based on simple regression analysis between the oral dose of Tac-OD and the total dose of Tac-IV during a 24-hour period.

Results

The AUC before and after conversion showed no differences. We found that the optimal initial dose of Tac-OD was 8 times the dose of Tac-IV. There was a relationship between the AUC and the trough level. No recipients experienced acute rejection or adverse effects such as renal failure, neurotoxicity, or cardiac failure during conversion.

Conclusions

We successfully converted continuous Tac-IV to oral intake of Tac-OD by adjusting the dose using trough levels without acute rejection or adverse effects. The AUC of Tac-OD correlated with the trough level. The optimal initial dose ratio of Tac-OD after Tac-IV was 8:1.     

Relationship between neuropathy proximal to the suprascapular nerve and rotator cuff tear in a rodent model

Background

Rotator cuff tears are believed to coexist with cervical spine lesions. In cases of preexisting neuropathy, such as cervical spine lesions, fatty degeneration has likely already occurred due to the neuropathy. In these cases, rotator cuff tear is thought to occur easily because of preexisting extensive fatty degeneration and degeneration of the tendons due to neuropathy. This study aimed to evaluate the effects of paralysis due to neuropathy proximal to the suprascapular nerve on the supraspinatus and infraspinatus tendons using a rat model of brachial plexus paralysis.

Chromosome analysis of human refrozen embryos following fluorescence in situ hybridization

Purpose  Several recent reports have discussed refrozen and thawed embryo transfer; however, the process may cause a degree of chromosomal damage and subtle genomic mutation. In view of this possibility, the purpose of this study was to investigate the incidence of aneuploidy in refrozen embryos. Methods  In order to investigate the incidence of aneuploidy and mosaicism observed in chromosome 1, fluorescent in situ hybridization (FISH) was used on surviving embryos that first underwent one freeze-thaw cycle, then were allowed to develop to the blastocyst stage, and subsequently survived a second freeze-thaw cycle. Results  Of 1,132 blastomeric nuclei analyzed from 15 refrozen embryos, disomy was found in 82.9%. In contrast, for the 11 blastocysts subjected to only one freeze-thaw cycle, disomy was noted in 78.4%. Of the 197 blastomeric nuclei analyzed in all arrested embryos, disomy was found in 51.8%. Conclusions  The refreezing process did not increase aneuploidy. The good and fair morphology groups demonstrated a higher percentage of disomy than the poor morphology group regardless of whether they were frozen once or twice.     

Increased production of cysteinyl leukotrienes and prostaglandin D2 during human anaphylaxis

Background Anaphylaxis is a life‐threatening syndrome resulting from the sudden release of mast cell‐ and basophil‐derived mediators into the circulation. However, pathological evidence of the association between inflammatory mediators and human anaphylaxis is insufficient. Objective The aim of this study was to better understand the relationship between in vivo production of inflammatory mediators and the pathogenesis of anaphylaxis. We also sought to evaluate mast cell activation in anaphylaxis. Methods We measured the concentrations of various inflammatory mediators in urine samples, which were collected from 32 anaphylactic patients during the onset of anaphlaxis and during clinical remission, 21 patients with asthma on acute exacerbation and 15 healthy control subjects. Blood and urine specimens were collected from the patients after provocation test. Urinary leukotriene E4 (LTE4), 9α, 11β‐prostaglandin F2 (9α, 11β‐PGF2), eosinophil‐derived neurotoxin (EDN) and leukotriene B4 glucuronide (LTBG) concentrations were determined by enzyme immunoassay, and the activity of plasma platelet‐activating factor acetylhydrolase and serum tryptase concentration were measured using commercially available kits. Results Significantly higher concentrations of urinary LTE4 and 9α, 11β‐PGF2, which immediately decreased during clinical remission, were observed in the anaphylactic patients than in asthmatic patients on acute exacerbation and healthy control subjects. Concentrations of EDN and LTBG were not significantly different among the anaphylactic patients, asthmatic patients on acute exacerbation and healthy subjects. There was a significant correlation between urinary LTE4 and 9α, 11β‐PGF2 concentrations in the anaphylactic patients (r=0.672, P=0.005, n=32). In addition, LTE4 concentration in patients with anaphylactic shock is significantly elevated compared with that in patients without anaphylactic shock. Conclusions This is a report on the significant increase in urinary LTE4 and 9α, 11β‐PGF2 concentrations during anaphylaxis. Urinary LTE4 and 9α, 11β‐PGF2 concentrations may be a reliable marker of endogenous production of inflammatory mediators associated with anaphylaxis.