Effects of continuous patient information in the dental environment

The effects of varying knowledge of an information system and belief in the effects of this information on discomfort during dental treatment were measured. The information system consisted of patient-operated buttons connected to a series of lights which provided continuous information to the dentist concerning the relative comfort of the patient. Actual information, false information, and knowledge of the information system were combined to form experimental groups. The results showed that those individuals with the ability to provide information to the dentist reported less discomfort than those without this ability during a scaling procedure. During the polishing procedure, the belief of the effect of information resulted in a decrease of reported discomfort.     

Ventricular enlargement after moderate or severe head injury: a frequent and neglected problem

The primary goal of this study was to determine the incidence of post-traumatic ventriculomegaly (Evans' index > or = 0.30) in 95 head-injured patients with a Glasgow Coma Scale (GCS) score of < or =13 at admission. Additional objectives were to determine the relationship between an increase in ventricular size and several clinical and radiological features and outcome. A planimetric study was carried out in the sequential control computed tomography (CT) scans of 34 moderately head-injured (GCS 9-13) and 61 severely head-injured (GCS 3-8) patients with a minimum follow-up of 2 months. Between two and six CT scans were evaluated in each patient. The presence of subarachnoid hemorrhage (SAH) was registered. Evans' index was determined in all CT scans. In the final CT scan of each patient, ventricular size was related to the admission GCS score, age, the presence of SAH in the initial CT scans, type of brain lesion (classified according to the final diagnosis in the Traumatic Coma Data Bank classification), and outcome. Ventriculomegaly was found in 39.3% of patients with severe head injury and in 27.3% of those with a moderate head injury. Increased ventricular size was evident 4 weeks after injury in 57.6% and 2 months after injury in 69.7%. No relationship was found between post-traumatic ventriculomegaly and age, initial GCS score, the presence of SAH, or type of lesion (focal or diffuse). Post-traumatic ventriculomegaly was significantly correlated with outcome. Post-traumatic ventriculomegaly is a frequent and early finding in patients with moderate or severe traumatic brain injury.     

Astrocytic connexin distributions and rapid, extensive dye transfer via gap junctions in the inferior colliculus: implications for [(14)C]glucose metabolite trafficking

The inferior colliculus has the highest rates of blood flow and metabolism in brain, and functional metabolic activity increases markedly in response to acoustic stimulation. However, brain imaging with [1- and 6-(14)C]glucose greatly underestimates focal metabolic activation that is readily detected with [(14)C]deoxyglucose, suggesting that labeled glucose metabolites are quickly dispersed and released from highly activated zones of the inferior colliculus. To evaluate the role of coupling of astrocytes via gap junctions in dispersal of molecules within the inferior colliculus, the present study assessed the distribution of connexin (Cx) proteins in the inferior colliculus and spreading of Lucifer yellow from single microinjected astrocytes in slices of adult rat brain. Immunoreactive Cx43, Cx30, and Cx26 were heterogeneously distributed; the patterns for Cx43 and Cx 30 differed and were similar to those of immunoreactive GFAP and S100beta, respectively. Most Cx43 was phosphorylated in resting and acoustically stimulated rats. Dye spreading revealed an extensive syncytial network that included thousands of cells and perivasculature endfeet; with 8% Lucifer yellow VS and a 5-min diffusion duration, about 6,100 astrocytes (range 2,068-11,939) were labeled as far as 1-1.5 mm from the injected cell. The relative concentration of Lucifer yellow fell by 50% within 0.3-0.8 mm from the injected cell with a 5-min diffusion interval. Perivascular dye labeling was readily detectable and often exceeded dye levels in nearby neuropil. Thus, astrocytes have the capability to distribute intracellular molecules quickly from activated regions throughout the large, heterogeneous syncytial volume of the inferior colliculus, and rapid trafficking of labeled metabolites would degrade resolution of focal metabolic activation.     

Surface modification of polypropylene nonwovens with LDV peptidomimetics and their application in the leukodepletion of blood products

For clinical indications and according to European standards, a depletion of the leukocytes from whole blood has to be realized before transfusion to a patient. In this study, the surface of a layer of meltblown oxygen-plasma treated polypropylene nonwoven (O(2)-PP), making part of the composition of leukodepletion filters, was modified with bioactive molecules to enhance the adhesion of leukocytes. These synthetic small molecules (called peptidomimetics) mimic the "Leu-Asp-Val" (LDV) tripeptide sequence recognized by the α(4)β(1) integrin, a receptor expressed on leukocytes. Their activity, as ligands of the α(4)β(1) integrin, was confirmed through cell adhesion assays. The peptidomimetics were covalently immobilized on O(2)-PP nonwoven via activation of the hydroxyl- and carboxyl-functions displayed on the polymer surface with trifluoro-triazine reagent, or were simply deposited on the O(2)-PP surface. The treated materials were characterized by X-ray photoelectron spectroscopy, wettability, and morphological analyses, before and after steam sterilization. Experimental filters composed of 10 layers of O(2)-PP nonwovens and a last layer modified with the peptidomimetics were evaluated, using whole blood filtration assays, for their leukodepletion efficiency, the recovery of red cells and platelets and the waste of blood, with an objective to design new filters fulfilling practical and medical criteria.     

Scopolamine attenuates tinnitus-related plasticity in the auditory cortex

High doses of salicylate induce a temporary hearing deficit and a temporary subjective tinnitus in humans and animals. In animals, salicylate suppresses activity in the ascending auditory system but generates activity and plasticity in the auditory cortex and central amygdala. In addition to changes in the auditory system evoked by hearing impairment, enhanced stress may be crucial for the salicylate-induced alterations in the auditory cortex. The central amygdala responds to stress, and may influence cortical excitability and plasticity through cholinergic mechanisms. We investigated whether salicylate-induced plasticity in the auditory cortex is prevented by blocking cortical cholinergic receptors with the muscarinic antagonist scopolamine. Scopolamine suppresses salicylate-induced plasticity in the auditory cortex and, therefore, may be effective in suppressing the tinnitus sensation.     

Analysis of Microglial Gene Expression

Microglia are the tissue macrophage of the central nervous system (CNS) and their activation is among the earliest signs of CNS dysfunction and disease. Because microglia express many macrophage markers, they are presumed to act primarily as effectors of CNS inflammation and destruction. While such responses are beneficial to the extent that they destroy CNS pathogens, these responses do have the potential to have neurotoxic outcomes. Consequently, therapies for many CNS neurodegenerative and inflammatory diseases have been directed at suppressing microglial function.There is evidence to suggest that microglia play an important role during CNS development and maintenance of CNS function that may go beyond simple defense against pathogens. Molecular analysis of microglial phenotypes and function has revealed three striking findings: (i) that microglia are a unique CNS-specific type of tissue macrophage; (ii) that they are highly heterogeneous within the healthy CNS; and (iii) that microglial responses are exquisitely tailored to specific regions of the CNS and specific pathological insults. We suggest that ubiquitous suppression (rather than targeted manipulation) of microglial function may fail to fully ameliorate CNS pathology and may even ultimately promote maladaptive outcomes.     

Incidence of maxillary sinusitis following Le Fort I maxillary osteotomy

Twenty adult patients with maxillofacial discrepancies most amenable to correction by Le Fort I osteotomy were evaluated for the incidence of postoperative maxillary sinusitis. Before surgery, each patient was evaluated both radiographically, by Waters' projection technique, and subjectively, according to a brief questionnaire pertaining to sinus symptoms. Identical evaluations were carried out at three- and six-month intervals following surgery. The results show no increase in the incidence of maxillary sinusitis following Le Fort I osteotomy.