Indications of antibiotic prophylaxis in dental practice- Review

Antibiotics are frequently used in dental practice. Clinical and bacteriological epidemiological factors determine the indications of antibiotics in dentistry. Antibiotics are used in addition to appropriate treatment to aid the host defences in the elimination of remaining bacteria. It is indicated when there is evidence of clinical sign involvement and spread of infection. Antibiotics are prescribed in dental practice for treating odontoge nic infections, non-odontogenic infections, as prophylaxis against focal and local infection. Special care needs to be addressed to patients with organ transplants, poorly controlled diabetes and pregnancy. Antibiotics should be used only as an adjunct to dental treatment and never alone as the first line of care. The present paper reviews the indications of antibiotics in dental practice.     

Ortner's syndrome: - case series and literature review

More than a century ago, Ortner described a case of cardiovocal syndrome wherein he attributed a case of left vocal fold immobility to compression of the recurrent laryngeal nerve by a dilated left atrium in a patient with mitral valve stenosis. Since then, the term Ortner's syndrome has come to encompass any nonmalignant, cardiac, intrathoracic process that results in embarrassment of either recurrent laryngeal nerve-usually by stretching, pulling, or compression; and causes vocal fold paralysis. Not surprisingly, the left recurrent laryngeal nerve, with its longer course around the aortic arch, is more frequently involved than the right nerve, which passes around the subclavian artery.ObjectivesTo discuss the pathogenesis of hoarseness resulting from cardiovascular disorders involving the recurrent laryngeal nerve along with the findings of literature review.Materials and methodsThis paper reports a series of four cases of Ortner's syndrome occurring due to different causes.DesignCase study.ResultOrtner's syndrome could be a cause of hoarseness of voice in patients with cardiovascular diseases.ConclusionAlthough hoarseness of voice is frequently encountered in the Otolaryngology outpatient department, cardiovascular- related hoarseness is an unusual presentation. Indirect laryngoscopy should be routinely performed in all cases of heart disease.     

17β-OESTRADIOL ENHANCES NITRIC OXIDE SYNTHASE ACTIVITY IN ENDOTHELIUM-DENUDED RAT AORTA

1. It has been suggested that oestrogen-produced vasodilatation is due to induction of endothelial nitric oxide synthase (NOS), but there are many reports of direct effects on vascular smooth muscle. In the present study, these processes were investigated in rat aorta isolated from ovariectomized rats. 2. Short-term treatment (10min) with 17β-oestradiol (10 μmol/L) produced a small attenuation of the phenylephrine (PE)-induced constriction, which was unaffected by the nitric oxide synthase inhibitor l-N 5(-1-iminoethyl)ornithine (NIO; 100μmol/L). Long-term treatment (6h) with 17β-oestradiol (10 μmol/L) did not affect acetylcholine-mediated vasorelaxation in endothelium-intact aortic rings, but did attenuate PE-induced constriction. This attenuation was also observed in endotheliumdenuded preparations after 17β-oestradiol (10 μmol/L for 6h) and was far greater than the acute effect of 17β-oestradiol (10 μmol/L). 3. The attenuation produced by 17β-oestradiol (10 μmol/L for 6 h) was significantly inhibited by concomitant treatment with cycloheximide (1 μmol/L), suggesting that protein synthesis was involved. NIO (100 μmol/L) also attenuated the effect, which suggests that the anti-constrictor effect of 17β-oestradiol occurs through the increased production of nitric oxide (NO). 17β-Oestradiol increased NO production, as assessed by the conversion of [³H]-arginine to [³H]-citrulline in rat aorta. These effects were prevented by cycloheximide and NIO. The anti-constrictor effect of oestrogen was blocked by the oestrogen receptor antagonist ICI 182780 (100nmol/L). 4. Western blotting using an antibody specific for inducible nitric oxide synthase (NOS) revealed that 17β-oestradiol (10 μmol/L for 24 h) treatment induced the formation of inducible NOS protein in the aorta, an effect blocked by cycloheximide. The results indicate that 17β-oestradiol can attenuate the vasoconstrictor effect of PE by a specific receptor-mediated process that involves induction of inducible NOS.     

Patient coping and expectations predict recovery after major orthopaedic trauma

Background

: Persistent post-surgical pain and associated disability are common after a traumatic fracture repair. Preliminary evidence suggests that patients' beliefs and perceptions may influence their prognosis.

The treatment of malignant histiocytosis

Twenty-four consecutive cases of malignant histiocytosis (MH) treated at Stanford Medical Center between 1973 and 1983 have been reviewed. Most patients presented with systemic symptoms (91%) and advanced disease (stage IV, 80%). Multiple organ involvement was common. In six cases, pathologic tissue was further characterized by frozen section immune histochemistry, using a panel of monoclonal antibodies known to react with monocytes and macrophages, as well as a variety of hematopoietic cells. One case expressed a mature monocyte/macrophage phenotype; three cases were considered null cell or primitive lesions; and two cases were identified as probable T cell lymphomas. Seven patients underwent splenectomy. Two patients died prior to any treatment. Twenty-two patients were treated with CHOP (cyclophosphamide, Adriamycin, vincristine, prednisone) +/- bleomycin (B), +/- midcycle high-dose methotrexate (HD-MTX) with leucovorin rescue. Seven patients received prophylactic intrathecal MTX. Of 22 evaluable patients, there was a 68% complete response rate (CR), a 23% partial response rate (PR), and a 9% no response rate (NR). Median duration of CR was 30+ months; median duration of PR was 2.4 months. Median survival for patients attaining a CR has not been reached v 3 months for the PR and NR groups. For all 24 patients, median survival was 2 years, with a 5-year actuarial survival of 40%. Multivariate analysis revealed that a platelet count less than 150,000 (P Cox = .005) and the dose of drug delivered (P Cox = .057) were the most important prognostic factors. Prophylactic intrathecal MTX therapy and splenectomy did not influence survival. Although MH is an aggressive disease with a poor prognosis, it is potentially curable. Systematic and aggressive treatment should further improve the outcome.     

Combination of exercise and losartan enhances renoprotective and peripheral effects in spontaneously type 2 diabetes mellitus rats with nephropathy

OBJECTIVES: We assessed the renal and peripheral effects of chronic exercise in a rat model of diabetic nephropathy and the benefits of combined exercise and losartan. METHODS: Heminephrectomized Goto-Kakizaki rats were divided into four groups: (i) no exercise (control); (ii) exercise with treadmill running; (iii) losartan; (iv) exercise plus losartan, and the rats were treated for 12 weeks. RESULTS: Losartan and exercise plus losartan significantly decreased systolic blood pressure (SBP). Exercise, exercise and losartan, and losartan blunted the increases in proteinuria. The index of glomerular sclerosis (IGS) and the relative interstitial volume of the renal cortex were significantly improved in the exercise, exercise and losartan, and losartan groups. The IGS, expressions of ED-1 and alpha-smooth muscle actin in the glomerulus were the lowest, and the number of Wilms' tumour was the highest in the exercise plus losartan group. The endurance, the proportion of type I fibre and capillarization in the extensor digitorum longus muscle were greater in the trained groups. CONCLUSION: These results suggest that both exercise and losartan have renoprotective effects, and the combination of exercise and losartan provided greater renoprotective effects than losartan alone, and may affect macrophage infiltration, mesangial activation, and podocyte loss in this model of diabetic nephropathy. It is also suggested that exercise has a specific renoprotective effect that is not related to SBP reduction, and can enhance endurance without renal complications.     

Orbital multiple myeloma: Case report and review of computed tomography features

Orbital involvement at diagnosis in multiple myeloma is rare. Only a few a cases are reported with computed tomographic features. We report a case of orbital myeloma, and relevant medical reviews on computed tomography features are discussed.     

人胰腺α-淀粉酶的cDNA克隆和原核表达的初步研究

目的 获得人胰腺α-淀粉酶(AMY2A)基因并进行原核表达。方法 采用基因工程技术,根据人AMY2A基因序列设计并合成特异性引物;从人胰腺组织中提取总RNA,反转录成CDNA第一链;逆转录-聚合酶链反应(RT-PCR)扩增人胰腺AMY2A基因,经BamH Ⅰ和Kpn Ⅰ双酶切、连接并插入原核表达载体pGEX-5T,构建pGEX-5T-AMY2A重组表达载体,在大肠杆菌BL21中异丙基硫代半乳糖苷酶(IPTG)诱导表达AMY2A蛋白。包涵体经尿素变性、复性及谷胱苷肽琼脂糖柱亲和层析纯化、AMY2A酶活性测定和免疫印迹分析。结果 重组质粒测序和酶切结果显示AMY2A基因已正确插入pGEX-5T,重组蛋白、复性及纯化产物SDS聚丙烯酰胺凝胶电泳(SDS-PAGE)在84 000处有一条明显的蛋白表达条带,AMY2A检测具有酶活性,免疫印迹分析表明重组蛋白具有人胰腺淀粉酶抗原性。结论 作者已克隆并在大肠杆菌中初步表达并获得纯化的谷胱苷肽转移酶(GST)-AMY2A融合蛋白。