Vital pulpotomy in primary molars

abstract – Vital pulpotomy was carried out on 28 primary molars of IT) children between the ages of 3 and 6 years. As dressing material zink oxide-eugenol cement was used in 14 teeth and Ledermix® cement in 14 teeth. Contralateral teeth were treated in 13 of the children. The observation period varied from 1 to 42 months. None of the treated teeth were painful during the period of observation. Internal resorption, evaluated radiographic-ally, occurred in six teeth treated with zinc oxide-eugenol cement, and in three teeth treated with Ledermix cement. No other complications were observed. Evaluated clinically and radiographically, the treatment was thus successful in 57% of the cases with zinc oxide-eugenol cement and in 79% of the cases with Ledermix cement. Histologically, the occurrence of internal resorption was of almost the same frequency in the two groups, but the degree of resorption was considerably less in the group treated with Ledermix cement. The inflammation of the pulp tissue in the area of the amputation was clearly more severe in the group treated with zinc oxide-eugenol cement than in the group treated with Ledermix cement. Accepting the importance of correct diagnosis, this histologic study indicates that Ledermix cement, as dressing material in vital pulpotomy of primary molars, is superior to zinc oxide-eugenol cement.     

The Antithrombotic Effect of Heparin in Deep Venous Thrombosis: Relation to Four Heparin Assays

Abstract In a prospective study, 280 patients with phlebographically proven deep venous thrombosis intravenous heparin infusion; 224 of the patients were subjected to control phlebography after 5–8 days of treatment. Females above 70 years showed least phlebographic improvement despite similar heparin dosage and heparin activity. Heparin activity in daily drawn blood samples was determined by four different assays. Chromogenic substrate (CS) assay (Coatest heparin), activated partial thromboplastin time (Cephotest), and thrombin time with recalcified plasma (CaTT) showed weak but significant correlations with thrombus resolution judged by phlebography (p=0.004, 0.003 and 0.018, respectively). A linear prediction equation showed that the phlebographic result was about equally influenced by the mean dose and by the result of any of the three heparin assays. Thrombin time with citrated plasma showed no correlation. CS assay and CaTT showed significantly lower mean heparin activity in patients with (n=13) than without clinically diagnosed pulmonary embolism (p=0.012 and 0.001, respectively).     

Carnitine in Seminal Fluid as Parameter for the Epididymal Funktion*,**

Carnitin im Spermaplasma als Parameter für die Nebenhodenfunktion Carnitin kann als ein Repräsentant des Sekretes gelten, das über den Ductus deferens dem Ejakulat zufließt. Über 94% des freien Carnitin stammen aus dem Nebenhoden. Die Häufigkeitsverteilung des Carnitingehaltes im Sperma bei Normalpersonen und Azoospermien wird dargelegt; die Korrelation mit den konventionellen Spermiogramm-Parametern wird besprochen. Bei verschiedenen andrologischen Krankheitsbildern wird auch unter besonderer Berücksichtigung von Vasoresektionen und Klinefelter-Syndromen die Wertigkeit der Carnitinbestimmung untersucht. Anhand von zwei kasuistischen Beispielen wird dargelegt, wie man aufgrund gleichzeitiger Bestimmung von Fruktose, Citrat und Carnitin einen hohen Samenwegsverschluß diagnostizieren kann. Split-Ejakulatuntersuchungen bestätiten, daß das freie Carnitin nicht aus den Bläschendrüsen stammt, sondern über den Ductus deferens dem Sperma zufließt.     

Atrial Fibrillatory Electrogram Measurement Allows Atrial Lead Placement in Patients Who Develop Atrial Fibrillation During Permanent Dual Chamber Pacemaker Implantation

The benefit of DDD(R) pacing is proven even in patients with intermittent atrial fibrillation. Atrial fibrillation developing during dual chamber pacemaker implantation creates a difficult problem. Maneuvers to reestablish a stable atrial rhythm often are required if atrial fibrillation sets in. This study was performed to determine if atrial lead placement can be performed with acceptable long-term results in the presence of atrial fibrillation. Twenty-one patients in whom atrial fibrillation developed during permanent pacemaker implantation were included in this study. In 12 patients, episodes of intermittent atrial fibrillation had been documented before the procedure. Screw-in leads were used in 15 patients and J-shaped passive fixation leads in 6 patients. AH leads were bipolar. The intraoperative atrial fibrillation electrogram amplitudes ranged from 0.9 to 3.2 mV (mean 1.8 ± 0.6 mV). One patient required lead revision due to a high atrial pacing threshold after conversion to SR. One patient remained in atrial fibrillation at 3-month follow-up. The other 20 patients converted to SR, 11 of whom had intermittent atrial fibrillation with successful mode switch activation. P wave amplitudes were 2.8 ± 6 mV (range 1.4 to 4.0 mV) after conversion to SR. The mean atrial pacing threshold was 1.1 ± 0.5 V (range 0.5 to 3.5 V). Placement of atrial leads in patients who develop atrial fibrillation during pacemaker implantation is feasible; fibrillatory electrogram amplitudes showed a good correlation with the atrial signal after conversion to an organized atrial rhythm (r = 0.698). Acceptable atrial pacing thresholds can be expected as well.     

A Technical Approach to Optimized Atrial Recognition in the ICD:

Present-day ICD systems offer the possibility to reconstruct an intrathoracic 6-lead ECG (IT-ECG), using the defibrillator coils in the right ventricle and superior vena cava and the left-laterally positioned ICD as electrodes according to Einthoven and Goldberger. The aim of this study was to assess the feasibility of (1) automated P wave recognition in the IT-ECG without an additional atrial electrode as the basis of AV synchronous ventricular pacing (VDD) and for improved differentiation between supraventricular tachyarrhythmias and, (2) the automated detection of pacing evoked atrial potentials (EAP) in dual chamber ICDs as the basis for atrial "autocapture " pacing systems. In 27 patients during ICD implanation intraoperatively, the IT-ECG was digitally recorded. A recently established algorithm for automatic P wave and EAP detection correctly identified 1,663/1,672 (99.5%) P waves (oversensing rate 0.6%) and 543/554 (98.0%) EAP (no oversensing). During subthreshold atrial stimulation, 405/412 (98.3%) P waves were correctly identified (oversensing due to pacemaker spikes,   n = 421   , without subsequent EAP, 1.9%,   n = 8   ). During stimulated ventricular tachycardia in 26/27 patients retrograde P wave or AV dissociation were identified. The 6-lead IT-ECG, easily implementable in ICD systems, is a diagnostic tool providing reliable information about atrial activation, serving as a basis for VDD pacing in single chamber ICD systems, allowing reliable EAP recognition that enables atrial "autocapture " pacing in dual chamber ICDs, and improves the differentiation between supraventricular and ventricular tachycardia. (PACE 2003; 26[Pt. I]:1472–1478)     

Inhalation Developmental Toxicity Study of Propylene Oxide in Fischer 344 Rats

The developmental toxicity potential of propylene oxide (PO)was evaluated in Fischer 344 rats following inhalation exposure.Four groups of 25 mated female rats were exposed to 0, 100,300, and 500 ppm of PO for 6 hr per day on Gestation Days 6through 15, inclusive. Cesarean sections were performed on allfemales on Gestation Day 20 and the fetuses removed for morphologicalevaluation. Exposure to propylene oxide did not adversely affectsurvival, appearance, or behavior at any of the exposure levelstested. Maternal body weight gain and food consumption werereduced significantly among the females at the 500 ppm levelduring the exposure period. No exposure-related effects werenoted with respect to maternal water consumption, organ weights,cesarean section, or fetal morphological observations with thesole exception of increased frequency of seventh cervical ribsin fetuses at the maternally toxic exposure level of 500 ppm.In summation, the no-observable-adverse-effect level (NOAEL)of propylene oxide. when administered to Fischer 344 rats viawhole-body inhalation exposure, was considered to be 300 ppm.     

The lateralized readiness potential preceding brief isometric force pulses of different peak force and rate of force production

Previous studies have reported that the lateralization of the readiness potential is unaffected by force amplitude of brief unimanual responses. However, Because those studies did not spectify rate of force production, response force probably was mainly controlled by force unit duration rather than by recruitment of force units, which may explain this negative finding. To enforce recruitment control, we factorially combined peak force (10% or 50% of maximal voluntary finger force) and time to peak force (100 or 200 ms). A precue provided advance information about the responding index finger (left vs. right). After 1 s, the imperative stimulus followed, requiring a brisk isometric flexion of the specified index finger. Symmetric effects, maximal at the vertex, of both force and rate of force production were observed 200–100 ms before the imperative stimulus in stimulus-synchronized averages and 200–100 ms before response onset in response-synchronized averages. However, neither force nor rate to force production affected the lateralized readiness potential. We conclude that this measure does not reflect movement parameters but appears to indicate an abstract preparation of lateralized response channels.